How to Help Someone with an Addiction

How to Help an Addicted Friend or Family member

This section will guide you on how to help someone with an addiction.

When someone struggles with addiction, it can have serious negative effects on their relationships with family, friends, and work colleagues. If you know or suspect that someone in your life suffers from alcohol or drug addiction, you will probably want to help the one that you love, but this can be met with hostility or denial.

Addiction is a chronic,  often relapsing emotional illness, and the path to recovery for someone who is addicted is often a long and difficult one. This inevitably impacts those closest to them, and professional help may be needed to get them to treatment and into recovery. 

Alcoholism | Drug addiction

Signs of Addiction

It is important for family members and friends to recognise the signs and symptoms of addiction.

These can differ depending on the type of addictions they are coping with, whether it be drugs, alcohol or gambling addiction. Many people are able to hide their addiction even from those closest to them, and it can be tempting to ignore the problem when that seems easier. Some of the most common signs that someone is suffering from addiction include:

Behavioural changes

  • Developing problems at work or school
  • Lying about the substance or how much they use
  • Becoming angry when asked about their use
  • Changing friends groups
  • Secretive behaviour, lying, stealing
  • Changes to normal habits or mood swings
  • Quitting social activities or Criminal behaviour

Physical Changes

  • Appearing intoxicated more often
  • Problems with memory or cognition
  • Unusual tiredness or Bloodshot eyes
  • Rapid weight fluctuations
  • Poor hygiene and grooming

3 Emotional & Behavioural Barriers to Addiction Treatment and Recovery

As much as you want to help your loved one, it is common for those who suffer from addiction to exhibit negative behaviours and attitudes when confronted about their using. Many people will react in the following ways:


Part of the reason that addiction is so difficult to manage and treat is that the person affected refuses to accept that they have a problem. It can be frustrating and confusing for those around the person affected to continue watching them behave in destructive ways and remain in denial when confronted.


When confronted, the person affected will deny they have a problem, and will commonly react in anger, initially or if pushed on the issue. People with an addiction will generally be feeling defensive and can turn aggressive if the issue of their using is raised. Even the “nicest” approach may be met with anger.


The person affected may start to avoid you, or avoid speaking about their problems, if they begin to feel “attacked”.  An addict will often use it as a coping method to avoid problems and may continue this avoidance behaviour, starting to shut themselves away from you and other loved ones that confront them.

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How to Deal with Stress without Alcohol

Stress is a natural reaction that occurs in response to our everyday experiences, and we all have to deal with it from time to time. Whether it comes from our day-to-day responsibilities like work and family, or serious events such as illness or death, stress is an inevitable part of our lives.

Problems may occur, however, if you begin dealing with stressful situations using unhealthy methods, like turning to alcohol. This page will explore how using alcohol to cope with stress can cause further harm to your wellbeing while also outlining helpful ways to manage these feelings.

Stress and alcohol in our lives

In the short-term, stress can actually benefit your health and can help you cope with potentially serious situations. Your body reacts to stress by releasing hormones that increase your heart and breathing rates so that your body is ready to respond to the challenge you’re faced with. However, if these stress levels stay elevated for longer than necessary, they can cause a variety of symptoms that take a toll on your overall health and well-being.

Why is it unhealthy to use alcohol to cope with stress?

Having a drink to unwind at the end of a busy day is a common habit, and something many people do. But when you begin using alcohol as a crutch to cope with certain feelings and emotions, you have to ask yourself whether this seemingly harmless habit has the potential to make your stressful situation worse by making you reliant on alcohol as your prefered way of coping with stress. As the weeks and months go on you will need to drink more and more alcohol to feel the same relaxation you used to after one drink.  

What is stress?

When we talk about stress, we’re referring to the feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stress is your body’s natural reaction to a challenge or demand.

Certain types of stress, in small bursts, can be positive thing. Such as when it’s needed to avoid danger or meet a deadline. Sometimes we all need an extra hard push in the right direction.

However, issues can occur when you find that you’re constantly stressed. Not only is chronic stress mentally exhausting, it can have adverse effects on you physically too. Stress is the body’s reaction to harmful situations – whether they’re real or not. A chemical reaction takes place – known as “fight” or “flight” and when you feel threatened, this reaction allows you to respond in order to protect yourself.

Feelings and emotions associated with stress:

Stress can affect all aspects of your life, including your emotions, behaviours, mental ability, and physical health. No part of the body is immune. Sometimes you might not even realise that the issues you are experiencing are a result of feeling anxious and stressed.

Psychological signs of stress:

  • Depression
  • Anxiety
  • Irritability
  • Restlessness
  • Overwhelmed
  • Unmotivated
  • Trouble sleeping or sleeping too much
  • Problems with your memory or concentration
  • Poor decision making 

Emotional signs of stress include:

  • Frustration
  • Agitation
  • Loss of emotional control
  • Difficulty relaxing
  • Low self-esteem

Physical symptoms of stress include:

  • Stomach problems (diarrhoea, constipation, and nausea)
  • Headaches
  • Low energy
  • Chest pain and rapid heartbeat
  • Muscle tension
  • Insomnia
  • Frequent colds and infections
  • Loss of libido
  • Sweaty hands and feet
  • Clenched jaw
  • Teeth grinding

stress worry
Photo by Adrian Swancar on Unsplash

Behavioural symptoms of stress include:

  • Changes in appetite — either not eating or eating too much
  • Procrastinating and avoiding responsibilities
  • Increased use of alcohol, drugs, or cigarettes
  • Exhibiting more nervous behaviours, such as nail biting, fidgeting, and pacing 
  • How does alcohol relieve stress?

Alcohol works by blocking chemical signals between brain cells, which results in feelings of intoxication, including impulsive behaviour, slurred speech, poor memory, and slowed reflexes. Its sedating qualities make you feel relaxed and numb both physically and mentally, however, consuming alcohol doesn’t actually rid you of the causes of stress, it simply masks the problem.

Despite its calming effects, it’s very important to be aware that alcohol can actually contribute to feelings of stress, anxiety and depression, and make stress harder to deal with overall. If you’re drinking more than the UK Chief Medical Officers’ (CMOs) recommended 14 units a week, it may be time to look at alternative coping mechanisms. 

Why does alcohol make stress worse?

Although you might make you feel relaxed, this is really down to the effect of alcohol on your brain and body. It’s important to remember that the effects of alcohol are temporary. If you choose to avoid the real cause of your stress, you’ll find yourself struggling to cope again as soon as you’re sober. This will lead to excessive drinking in order to rid yourself of the feelings and emotions that are causing you discomfort. 

Reacting to Stress

When you’re feeling anxious or scared, your body releases stress hormones called adrenaline and cortisol. This is helpful for those that need a little nudge when it comes to getting things done. But it might also cause physical symptoms such as a faster heartbeat or sweating, and if you’re constantly stressed this can become a problem.

Studies have found that cortisol interacts with the brain’s reward systems, which enhances alcohol’s reinforcing effects. This means that you would need to consume greater amounts to achieve the desired feeling. Alcohol elevates the brain’s cortisol level and ultimately altering the brain’s chemistry and resetting what the body considers to be “normal.”

Managing stress isn’t a life skill that we’re taught at a young age, which is why we’re sometimes caught off guard when it comes to dealing with real-life situations. Some people are able to take everything in their stride while others become anxious almost immediately.

If any of the reactions below seem familiar to you, then it’s likely that you’re not coping well with stress. Using unhealthy coping mechanisms, can give way to a range of other issues, such as alcoholism or addiction. Many of the reactions below we do unconsciously, so it’s important you recognise them when they do occur.

Physical pain

If you’re feeling unexplained pain or muscle tension, especially in your neck and shoulders, you may be reacting to something by clenching your fists or your jaw.


Our digestive system is linked to our moods, so feelings of stress might trigger overeating or undereating, resulting in weight loss or weight gain.


Stress can often cause you to be short-tempered, and you may find yourself more confrontational with people even without being provoked. If you find yourself getting angry over something insignificant, it means you haven’t taken the time to deal with the source of your stress, and so it is manifesting in other ways. 


While crying may be cathartic every once in a while, stress may trigger long periods of sadness and crying, sometimes without warning. It may be things completely unrelated to your stress that leaves you in tears.


Sometimes stress may be too much to take. You might avoid the problem, call in sick to work, feel hopeless or simply give up. Chronic stress can be a factor in the development of depression or anxiety disorders.


Even if you haven’t had a drink for a while, you might discover that it’s a quick and easy way to relax when you’re under pressure. In fact, stress is a leading cause of alcohol relapse with many people turning to drink to avoid feeling burdened by their emotions.  

Side effects of stress

We spoke earlier on in this article about the signs of stress, and the longer those stress indicators linger, the more likely they are to become side effects. Excess stress can result in:

  • Ulcers
  • Heart disease
  • High blood pressure
  • Backache
  • High blood sugar
  • Insomnia
  • Fertility problems
  • Loss of libido

Different types of stress

Most of the time, you’ll know what’s causing you stress, but other times you may not realise the affect that something is having on your mental and physical wellbeing. A helpful way of identifying what’s triggering your stress is to make a list of all the different areas in your life. You may discover things that you hadn’t realised were an issue.

Financial stress

Financial stress is a huge burden for many people, with many drowning their sorrows and looking for

Family stress

Family life can be stressful in many ways. Whether it’s fractured relationships, childcare or

Work stress

The workplace is considered to be the central hub of stress for many people. Whether it’s a fast-paced environment, tight deadlines or not getting along with co-workers.


Health problems can cause a great deal of stress, but what many people fail to realise is that the added stress can do a lot more to worsen any existing conditions.

Social media

Social media has grown in popularity fairly recently and while many might underestimate its impact, it is appearing consistently high on the list of things that cause stress, especially for young adults and Millennials. The term ‘technostress’ has been coined to express this unique type of stress.


Dealing with legal matters, whether it’s family or business-related, can be extremely stressful. Self-medicating to deal with these situations is not uncommon. 

alcohol stress
Image by Bastian Riccardi from Pixabay

How stress and drinking alcohol creates a vicious cycle

Stress and substance abuse often go hand-in-hand. Stress can lead to excessive drinking, but excessive drinking can also lead to more stress, as well as anxiety and depression. If you’re using one to deal with the other, you may find yourself stuck in a vicious cycle before you know it.

Drinking more than planned
Drinking more than planned

Once you begin to drink alcohol as a way of dealing with stress it’s easy to fall into the habit of using it to help you cope with other issues.

Alcohol is a sedative and depressant, and although it produces calming effects, excessive drinking can also result in other mental and physical health problems. The Jellinek curve was coined in the 1950s and has since been referred to regularly when discussing alcohol abuse. It begins by talking about the start of a drinking problem and then moves through physical problems like neglecting food and appearance, and mental problems like guilt, resentment, and a change in moral compass.

However, the Jellinek curve doesn’t end at the bottom with “excessive drinking”, it continues moving upwards into the “rehabilitation” phase.

Coping with the source of the problem 

Once you’ve found a coping mechanism you think works, it’s easy to become reliant on that way of dealing with things like stress. While it may have started off as drinking to forget a stressful day at work, that can very quickly turn into a problem.

In order to prevent stress, it’s important to address the actual cause of it. While alcohol will mask the symptoms, it won’t get rid of what’s triggering them.

People often find it difficult to be forthcoming about their feelings and emotions but opening up about things that are troubling you can do a world of good.

Coping with the symptoms of stress without alcohol:

If you’ve been using alcohol as a way of dealing with stress, you’re in danger of becoming dependant on it to get you through difficult times. There are many healthy ways to manage stress that won’t result in any potential harm. Making sure you try just a couple of these things a week could reduce your stress levels significantly. 


Any form of exercise is beneficial to your overall health and wellbeing.  People who have a regular exercise programme are less depressed, less stressed, less anxious and have more self-esteem. When you exercise, your brain releases endorphins, also known as ‘happy hormones’. Your brain naturally produces this calming and soothing effect, without the need for alcohol.


Relaxation techniques such as meditation are a fantastic way to learn how to clear your mind and breath through the stress. Making time for yourself will allow you to relax without any outside interference so you can truly focus on de-stressing.

Share the stress

Sharing your thoughts and feelings with another person is so invaluable. Not only will it provide you with a great sense of relief, it helps others better understand your situation and what you’re going through. If you don’t feel comfortable talking to someone you know, it’s a good idea to seek regular therapy in order to prevent these feelings building up.

Set boundaries

It’s important to set boundaries when it comes to people or situations in your life that might be contributing to your stress. Recognising when you’ve had enough and need some space is very important.

When does stress need medical treatment and what can you do to treat it?

If you find yourself using potentially damaging methods to deal with your stress, then it’s probably time to consider seeking alternative treatments to help alleviate that.

Therapies such as CBT, mindfulness, yoga and acupuncture have long been used to help combat feelings of stress and help you react more effectively to the situations behind it.

While there are available medications to help people cope with stress and anxiety, this isn’t always a recommended solution, as it does nothing to target the main source of stress and may end up becoming addictive.

If you’ve noticed that your drinking has become much heavier and more frequent, or you can’t get through your day without a drink to keep you calm, then you should seek help sooner rather than later. You may not be aware that your use of alcohol is only contributing to any feelings of depression and anxiety, while you think it’s helping you deal with stress, it’s doing just the opposite. Read more about why residential rehab might be the right option for you.

Why Does Alcohol Cause the Shakes?

Dr Peter McCann


This article is medically reviewed by Dr Peter McCann, MSC, MBBS. Dr McCann is a is a Psychiatry and Internal Medicine Resident at Duke University Hospital, USA.



What are ‘the shakes’ and what causes them?

The ‘alcohol shakes’ is a term to describe tremors caused by Alcohol Withdrawal Syndrome, which occurs in some frequent alcohol users when they suddenly stop drinking. 

It is part of a condition called alcohol withdrawal syndrome that occurs in around 50% of people with heavy alcohol use. In the mild form, typical symptoms other than tremor include anxiety, sweating, nausea, restlessness, headaches and alcohol craving. More severe forms of withdrawal can result in seizures, delirium tremens and hallucinations – and without treatment can lead to death.

Why do I shake after drinking alcohol?

It’s not actually the presence of alcohol that causes the shakes or tremors, but the sudden absence of alcohol in the body when the body has become used to its presence.

Withdrawal symptoms are a result of physiological imbalances which happen after a prolonged period of heavy drinking.

What’s the science behind alcohol shakes?

Alcohol has a depressant effect on the body, and heavy consumption can lead to the brain becoming used to a reduced level of stimulation. In more scientific terms, alcohol reduces activity of the central nervous system, by increasing the activity of the main inhibitory (depressant) neurotransmitter gamma-aminobutyric acid (GABA).

In response to the chronic increase in GABA activity, the brain reduces the number of GABA receptors in parts of the brain, in order to compensate.

When alcohol leaves the body, the brain has less of the depressant effect of alcohol but also fewer of the depressant GABA receptors because of the now reduced number. This leaves the brain in an overall excited state and this is what causes the tremors or shakes. 

Are alcohol shakes serious?

Having the shakes can be irritating and embarrassing, but isn’t serious in itself. It is however a sign of alcohol withdrawal which in some patients can lead to much more serious consequences. It is also a strong indication that the person has a severe alcohol use disorder.

Complicated alcohol withdrawal can lead to hallucinations, seizures or “delirium tremens” – a medical emergency that requires specialist inpatient care.

Alcohol shakes can occur after a few hours after drinking, and alcohol withdrawal seizures typically occur between 6 and 48 hours after stopping or reducing drinking. After 48-72 hours they may get delirium, which can cause death.

What is delirium tremens?

Delirium tremens is a neurologic syndrome resulting from and marked by changes in mental status and autonomic nervous system excitation. Symptoms may include confusion, anxiety, fever, body tremors, rapid heartbeat, sweating, severe confusion, agitation, hallucinations, and high blood pressure.

Alcohol withdrawal delirium has a high mortality rate – of about 8% – and so it is important that people are treated in a safe and secure environment, by clinicians who understand the condition.

What medications treat alcohol shakes?

When alcohol shakes and tremors become more than just a bad hangover and are signs of alcohol withdrawal, clinical interventions are needed.

Medicines called benzodiazepines can lessen alcohol withdrawal symptoms, and commonly include chlordiazepoxide (Librium) and lorazepam (Ativan). These drugs are typically used to treat anxiety, seizures, and sleep disorders due to the calming effect that they have on the nervous system.

In a residential detox and rehab centre, the withdrawal process is carefully monitored by medical staff, to minimise potential risks. The process of detoxification involves weaning a person from a substance in a safe and effective manner, by gradually tapering out its use. This minimises the withdrawal symptoms and helps prevent complications.

How long do shakes from alcohol withdrawal last?

The duration and severity of withdrawal symptoms vary depending on how much someone drinks, for how long, and how regularly. Other factors such as age, gender, weight and family history of addiction also have an impact.

It’s important to realise that if you have the shakes when you stop drinking, it’s a sign that your body has become dependent on alcohol, and that’s a sign that it’s time to get help.

What’s the safest way to treat someone who has alcohol shakes?

Because of the risk of delirium tremens – and the fact it can cause death – if someone suffers from severe alcohol shakes it’s important to seek a safe, medically-led detoxification programme, where your symptoms can be managed carefully.

Alcohol detox and rehab

The safest way to detox from alcohol if you have been drinking heavily for a long time is under the care and guidance of trained medical professionals in a detoxification unit or in a residential rehab hospital that has 24/7 nursing care and a 24/7 onsite doctor.

The medical staff will ensure that you receive a slow, safe, supervised detoxification from alcohol at a rate that is comfortable for you and they will be able to support you through the side effects of alcohol withdrawal. 

Once you have finished detox you will be able to join in the therapy programme and begin your recovery into a life free from alcohol.

At Castle Craig, we offer 24/7 nursing support with an onsite doctor in our specialist detoxification unit. Once detoxed patients join the main therapy programme which is based on the world-renowned 12 Step model of treatment, which is abstinence-based.

Through the programme, you will join in group and individual therapy to tackle your addiction and underlying mental health issues, such as trauma, that are contributing to the desire to drink alcohol. By joining in a programme like this you will eventually be able to leave alcohol behind and begin a new life in recovery. 

Learn more about how to detox from alcohol safely

Real-life story

I started worrying when I was still working in a bakery at the age of 21. I started noticing that every day around the end of my shift I got really anxious and shaky. I knew from the start it was because of a lack of alcohol in my system. Yet I kept drinking as soon as my shift was over. I now realize I should’ve stopped there but I was scared of the withdrawal so I didn’t. That was a mistake back then.

Years later when I was 28 years old, I knew I had a serious problem for some years but I was too scared to admit it. One evening when I was thinking about my future I thought to myself… When I grow up I want to be…

Then I realised I was already grown up. And I should’ve been there already. I made the choice then and there that I was going to quit the bottle and get my life together. I didn’t yet know-how. I talked to my girlfriend about it and she didn’t support it. She wanted us to keep drinking and having fun. For me, the fun had been over for a long time.

If you worried about yourself or a loved one and want advice on residential alcohol detoxification contact our Admissions Department who will be happy to answer your questions.

Photo by Tim Mossholder on Unsplash

Cocaine Overdose: Symptoms & How to Help

To a user, cocaine has this magical effect that makes you think you can keep going, no matter what. Your brain can’t handle another hour of work? “A line can fix that.” Too tired to party all night? “A line can fix that too.” Unfortunately, this superhuman feeling extends beyond that, and often makes people believe they can handle more cocaine, or any drug, than is possible in reality. And that can easily lead to a cocaine overdose.

While most people associate drug overdoses with becoming comatose and stopping breathing, as in opioid overdose, an overdose can broadly be defined as poisoning that occurs when a drug is taken in excessive amounts.

If you are worried that you might overdose on cocaine but don’t know how to stop, then you should consider rehab treatment to break the cycle of addiction and rebuild your life, free from drugs. Treatment at Castle Craig residential rehab clinic will help you to break free from cocaine addiction. Fill in our online admissions form and we will call you back.

Yes, You Can Overdose on Cocaine

Some people may find it hard to believe that a cocaine overdose is possible. If you’re a user, you are likely to have met someone who claims that they “can do 10 grams in a night and feel fine the next day”. They probably aren’t lying, but it doesn’t mean everyone can do the same 10 grams.

Cocaine overdose is difficult to define, because there are so many factors that are involved. In addition, a claimed overdose isn’t always an overdose. If you take too much cocaine, you’re likely to exhibit rather unpleasant symptoms long before you reach the overdose limit. Many users mistake a panic attack for an overdose, which can be scary and unpleasant. A major overdose can result in a number of serious medical outcomes including heart attacks, strokes, hypertensive emergency, malignant hyperthermia and seizures.

How Much Cocaine Causes an Overdose?

This is a commonly asked question that does not have a definite answer. Namely, because any medical professional will say, “It depends”. Although this is the case with many drugs, with cocaine it’s even more complicated.

It doesn’t matter if you’re a first-time or ongoing user, even one gram in a night can result in an overdose. Alternatively, you could be either, and still manage to survive a ten-gram binge. What will or won’t happen depends on many factors.


It may seem that there is never a straight answer when it comes to “how much is too much” regarding drugs, and the universal explanation is always tolerance. It is an important factor to keep in mind because every person has a different tolerance, natural or acquired, to every drug.

With cocaine, tolerance can be hard to pinpoint because one might be a heavy weekend user, while another may be a daily user. Regardless, cocaine is a drug that keeps you wanting more and more, so tolerance can build up very quickly after repeated use. However, it can also (although not always) reset if the use is occasional.

A reset of a tolerance may seem like a good thing but it’s actually quite risky. If a person is used to a certain amount, but then takes a break, they may think they can use the same amount on the next round. However, if their tolerance did reset, that portion can lead to an overdose.


Most cocaine sold on the street is far from pure. However, that may be a good thing, as truly pure cocaine is quite dangerous. At the same time, it’s also a very bad thing, for reasons to be discussed later.

Street cocaine can largely vary in purity, typically anywhere from 10-90%. Although some “cocaine” can have less than that or none at all.

Purity, of course, plays a large role in how much one can take. With pure cocaine, it can take as little as a few lines to trigger an overdose, and largely depends on your tolerance and body weight.


Closely related to purity, adulterants play a large role in risk for overdose as well. Adulterants are often added to street cocaine to enhance the high, not only to dilute it.

Common adulterants include caffeine, amphetamines, crystal meth, lidocaine, aspirin, levamisole and occasionally fentanyl or other opioids.

Some of these medications – such as aspirin or caffeine – will cause very little noticeable effect or problems. Others – such as amphetamines – are designed to mimic the effect of cocaine and are cheaper for the sellers who are cutting it. Others such as fentanyl can cause euphoria but carry a significant risk for respiratory depression and death.

Drug Interactions

Drugs which enhance or add to the effect of cocaine can also increase the risk of toxicity. These include amphetamines, crystal meth, methylphenidate and other stimulant type drugs. This is because many of these drugs act in similar ways to increase the amount of noradrenaline and dopamine in the central nervous system which can also result in some of the toxic effects.

Method of Administration

How you consume cocaine will determine its effects and thus determine the likelihood of an overdose. Smoking and injection produce the most rapid and strongest effects, and bypass any protective metabolic processes, thus making an overdose more likely. Consumption via snorting (nasal insufflation) is by no means safer, but would require a larger amount to cause an overdose.

Take a bottle of wine, for example. You can divide that bottle into three glasses over three hours (insufflation), or you can drink the entire bottle straight up (injection).

Repetitive Dosage

Cocaine has a peculiar effect where repetitive doses tend to build on one another. A single line, on its own, takes full effect in 30 minutes and lasts for about 90 minutes. However, if that dose is repeated multiple times, the effect is felt sooner and lasts much longer. Furthermore, at some point, a repeat dose will act much stronger than it is, and thus can trigger an overdose.

Going back to the bottle of wine example: If you spread the bottle over a period of time, by the third glass, you’re likely to be tipsy. However, if it were cocaine, that third glass will have the effect of drinking a second bottle.

Symptoms of a Cocaine Overdose

An overdose happens when your body or brain is overstimulated by cocaine. This can result in a number of unpleasant psychological and physiological symptoms. To avoid a cocaine overdose, it is wise to look out for signs of excessive use, especially if they don’t improve within a reasonable timeframe.

A cocaine overdose can happen unexpectedly, and presents itself in the following symptoms:

  • High blood pressure
  • Irregular or rapid heartbeat
  • High body temperature
  • Nausea/vomiting
  • Muscle twitches or tremors
  • Lightheadedness/dizziness
  • Difficulty breathing
  • Chest pain
  • Seizures
  • Slurred Speech
  • Arm or leg weakness
  • Panic attack
  • Aggressive behaviour
  • Anxiety
  • Paranoia
  • Hallucinations
  • Psychosis

The Aftermath of a Cocaine Overdose

A cocaine overdose is extremely scary. Anyone who has experienced it will tell you it is not something they’d like to repeat. Unfortunately, the after-effects are also unpleasant.

An overdose can lead to long-term physical damage and psychological complications. The rapid elevation in heart rate, blood pressure, and body temperature can trigger a heart attack, stroke, seizure, or organ shutdown. If a person is in less-than-perfect health to begin with, the aftermath can be fatal.

In addition to the heart, the kidneys, brain, eyes, muscles, bones, and gastrointestinal system can sustain significant damage from a cocaine overdose. A person may also develop chronic psychosis or a decrease in mental functioning.

How to Help During a Cocaine Overdose

1. Call an ambulance

Cocaine is a drug that takes rapid effect, so the first thing you should do is call emergency services. In the UK, if you’re a recreational user, you don’t have to fear police involvement. You will get the help that you need.

2. Stay calm

While you’re waiting for medical personnel to arrive, try to calm yourself down as much as possible.

3. Stay cool

An overdose also causes a rapid rise in body temperature, so it helps to cool yourself down. You might not be able to handle a cold shower, but you can place an icepack, frozen peas, or chilled bottle of water at the top of your head, back of your neck, under your armpits, and anywhere else you feel it helps.

4. In case of seizure

If a person is having a seizure, try to place them in an area where they’re less likely to injure themselves, such as a carpeted floor, away from sharp furniture corners.

5. Give the right information

Once the medical personnel arrive, they may ask you how much cocaine you have consumed and whether you consumed any other drug, including alcohol, at the same time. It is important to give them all the information they need to administer the right treatment. They may ask to take the drug you (or your friend) consumed in which case you should give it to them. The main reason is because they will test it in order to be able to provide the appropriate treatment. There have been many situations when a person thought they were taking cocaine, but in reality they were taking meth.

The first thing the medical personnel will do is apply first aid, similarly to what was described before. They may also give some medication to lower the heart rate and blood pressure. Usually, this is a benzodiazepine. After the patient is stable, they will perform a series of tests to determine if any damage resulted because of the overdose.

An Overdose is a Sign of Addiction

If you or your friend experiences an overdose, it is time to rethink what you’re doing. If an overdose happens again, it is definitely a sign for help. A cocaine overdose is not a pleasant experience. Therefore if a person continues to use, let alone overdoses again, it is likely to be a sign of addiction.

One of the tell-tale symptoms of addiction is continuing with a behaviour despite negative consequences. If a person is truly addicted to cocaine, they will be likely to brush off an overdose (or multiple overdoses) until the damage is irreversible. Hence, it is important for a person to get help as soon as possible. The impact of an overdose can “sober up” a person to reality for a while, so it may be a good moment to address the issue at hand and look into getting cocaine addiction treatment.

This article is medically reviewed by Dr. Peter McCann, MSC, MBBS. Dr McCann is a Psychiatry and Internal Medicine Resident at Duke University Hospital, USA.

Coronavirus (COVID-19) Safety Response

Castle Craig is open and Covid-free and we continue to offer our much needed residential addiction treatment for patients during the Coronavirus pandemic. Travel to Scotland from the rest of the UK and all European countries is allowed for healthcare purposes.

These are difficult times and we want to reassure our patients, their families and people who desperately need treatment for alcohol and drug addiction, that we are committed to providing the safest environment for recovery possible. We have taken special measures to ensure that our clinic operates safely and some complementary therapies have been paused.


Information on Actions & Measures Taken at Castle Craig Hospital

We have been open and operating throughout the Coronavirus pandemic, and we continue to provide access to essential acute medical and clinical care. Alcohol and substance use disorders are amongst the most prevalent of mental health disorders globally and alcohol and drug users are at greater risk of Covid-19 due the health impact of alcohol, lack of self-care, and social-isolation, which can lead to an increase in alcohol/drug consumption and increase the risk of suicide. Alcohol and drugs also have a deleterious effect on the immune system reducing virus resistance and immunity. Alcohol sales have risen significantly and the already rising death rates from alcoholic liver disease are likely to rise further.

We are therefore pleased to continue to offer essential clinical care at this time and ensure the continuation of our duty of care for people suffering from alcohol and drug addiction.

Accreditation of Safety Measures


Castle Craig’s special Covid-19 Safety measures have passed inspection tests by our regulating body ‘Healthcare Improvement Scotland’ who made a recent inspection in December 2020. They found our Covid-19 measures to be ‘Good’ and ‘Exceptional’.

They found that: Comprehensive and thorough COVID-19 risk assessments had been carried out and effective actions were being taken to minimise the risk of COVID-19 transmission. The hospital’s environment and patient equipment were clean and cleaning procedures followed current national guidance.

Clear and decisive leadership and assurance structures were in place, as well as a supportive approach for patients and staff. A coronavirus response management group had been set up to co-ordinate a hospital-wide response to the pandemic. The risks from COVID-19 had been thoroughly considered and clear actions were being taken to minimise the risk of transmission. The hospital’s quality management system was accredited to internationally recognised standards.

We have also received the BUPA Covid-19 Safety Badge from Bupa health insurers, on the of the UK’s leading health insurance providers.

At Castle Craig Hospital we are committed to providing compassionate care and a clinically proven treatment programme for people suffering from addictions. Our priority is always to ensure the health and safety of our patients and staff.


Covid-19 Response Updates

Since the very start of the pandemic we have had a Major Incident Covid-19 Response Team composed of Senior Management, Clinical Staff, infection control nurses and other relevant managers. Working closely with Public Health Scotland, and in light of changing events and guidance, we are taking the following action:

Our Treatment Programme during the Pandemic

The safety of our patients is of the utmost importance to us and as such, we have had to restrict parts of our treatment programme in order to ensure social distancing regulations and hygiene best practices.

Certain additional non-essential complementary activities which are an optional element of your treatment plan may not be available, for example we pushed back the re-launch of our hyperbaric oxygen therapy facility so that we can maintain our high level of infection prevention control and ensure the safety of our patients. In line with government guidelines some hands-on therapies, which require close physical contact for a long period, may not allowed to be made available if government guidelines dictate e.g. aromatherapy massage and head massage. Please ask our admissions department for more information on what we currently provide as the guidelines change fairly regularly.

Due to social distancing measures we cannot offer group equine therapy, however we are offering our dog walking as an option, and other animals such as our alpacas, ponies, pigs, sheep and the abundant wildlife are still onsite for patients to interact with and enjoy.

We are pleased that we can provide some art workshops and drumming. Our clinical team can provide acupuncture which assists with insomnia, anxiety and withdrawal symptoms. We are pleased that patients can stay active through a daily fitness programme with gym use in small groups, country walks, yoga stretching and pilates.

We do again want to stress that these adjunct, holistic therapies are not essential aspects of your treatment plan and we have found equally beneficial replacements for them which minimise any risk of the spread of Covid-19.


Taking full advantage of the fact we have a 50-acre property with many separate buildings, we are able to safely isolate people on admission.

We are admitting new patients to our dedicated Kirkurd Admissions & Medical Unit, where patients will spend the first week of treatment in isolation, focussing on detoxification, assessment and preparation of individual treatment plans, using virtual platforms where possible. During this first week patients will also be tested for Covid-19 twice, even if they show no symptoms.

If new patients remain healthy they will then transfer to the Castle or Recovery Gardens to complete their treatment within the larger patient community.

To arrange an initial assessment or for any questions on how this will work for you, contact our Admissions Team.

Covid-19 Screening

Increased screening for new patients takes place both before admission, during admission and during the first week of treatment in isolation. All new patients are Covid-19 PCR (antigen) tested for coronavirus twice in our admissions and detox unit before they join in with the main treatment programme. All patients and staff are screened on a daily basis, and Personal Protective Equipment (PPE) is used for all appropriate contact. Staff receive a monthly Covid-19 swab test. Our staff are screened with swab tests monthly. 

Infection Control

The safety of our patients and staff is of the utmost importance to us and we are maintaining the highest level of infection control and sanitisation throughout the whole hospital and all buildings. We have implemented hand hygiene protocols in accordance with guidelines issued by Public Health which include:

  • hand hygiene training for staff and patients;
  • specific Covid-19 cleanliness and hygiene measures within the hospital,
  • sanitisation stations are located in numerous locations throughout the hospital;
  • and applying social distancing measures in accordance with guidance and the avoidance of non-essential close contact.

All staff at Castle Craig are required to wear masks when in each others offices and when among the patient community. Therapists hold sessions while wearing a mask or with a perspex screen to divide the room and prevent droplet spread. Communication between staff in different departments is kept to a minimum and many staff who can work effectively from home still do.

We provide staff with a packed take-away lunch in place of a hot meal we used to provide in the dining room. Social distancing is actively monitored and all key rooms throughout the hospital have been assessed for maximum numbers of people.

Online Meetings and Programmes – Castle Craig Online

As in many other healthcare practices and clinics, the use of digital technology has enabled us to deliver effective Consultant Psychiatrist consultations through telemedicine; families are able to attend therapy through online platforms; our weekly aftercare groups and family therapy sessions have been moved online and virtual platforms are also used for attending AA and NA recovery fellowship meetings and these are highly successful.

Castle Craig has offered an online Continuing Care programme for several years to support patients at home once discharged from treatment; we encourage any former patient who is finding the current challenges difficult to contact us if they would like to know more about this online therapy.

Gym and Massage

We are able to offer some hands on therapies such as aromatherapy massage and Indian head massage at this time. Our practitioners take all required precautions in line with Scottish Government guidelines. 

Our gym is operating with enhanced hygiene and cleaning of equipment, good ventilation, smaller groups, purpose-built perspex separating screens and staff wear masks.


Unfortunately no visitors are permitted at present but patients are able to connect with family and friends through phone and online.


Regular updates are given to staff through the management system and in staff meetings where social distancing is observed. Staff have been given guidance around extra hygiene measures and 2 metre social distancing. Staff are aware that they must take their own precautions when offsite and are aware of the symptoms of Covid-19.

We would like to thank our wonderful team of dedicated therapists and nurses and all staff who continue to place their duty of care to our patients at the forefront of their work.

Increased Patient Communications

Patients are receiving regular communications from staff through community meetings, special noticeboards and with their Unit Lead Therapists. Family members and Friends of Castle Craig can keep up to date on the latest developments on our website and through social media or by calling us on 01721 722763. This web page will be updated frequently.

Ongoing Monitoring of the Situation Through the Most Reliable Channels

We are monitoring all developments on the Coronavirus front, news and recommendations from Health Protection Scotland, the Government and Chief Medical Officer and the WHO to ensure that current best-practices keep our patients and staff healthy and safe. This is a dynamic and changing situation so we will continue to monitor updates to the situation and will respond accordingly.

Our Commitment to Patients, their Families and our Staff

As a medical establishment our patients’ treatment and safety remain our primary concern. We are taking these steps in a careful and thoughtful manner to ensure that our patients can continue to receive the highest level of care in the safest possible environment and to ensure staff safety. We thank our patients, their families and our referral network for the trust placed in us at this time and we are confident that we have the clinical and managerial expertise as well as top facilities available to us on our estate, to face the challenges presented at this time.

For more information about coronavirus visit the NHS coronavirus page or read the latest government advice.

For more information on any of the above please contact us on or by phone on 0808 231 9583.

With kind regards,

Dr Margaret McCann, MD, CEO


Castle Craig Rated ‘Exceptional’ in Latest HIS Inspection

Castle Craig had an inspection from our regulators Healthcare Improvement Scotland (HIS) recently and today we have received the official report. 

They found our infection prevention and control policies and procedures, were excellent and comprehensive. They commented on the thorough Covid-19 risk assessments which had been carried out and the effective processes we had in place to minimise the risk of Covid-19 transmission.  

The inspectors commented on the positive attitude and evident teamwork of all the staff that they spoke to, and also the supportive and appreciate attitude of the patients.

HIS uses the ratings ‘Exceptional’, ‘Good’, ‘Satisfactory’ or ‘Unsatisfactory’, with Castle Craig receiving only the highest two gradings in this report.

  1. Our Delivery of care was rated Good  
  2. Leadership of improvement and change was rated Exceptional      

It is extremely difficult to achieve an Exceptional rating, and all staff who have contributed to this outcome should be very proud of this result. Dr McCann’s leadership throughout the inspection undoubtely had a factor in our exceptional grading.

We have no requirements or recommendations to meet going forward, which is very positive reflection of the hospital.

Dr McCann, CEO of Castle Craig said “This exceptional result wouldn’t have been possible without the drive and determination of our dedicated team of staff who worked tirelessly to ensure our Covid safety standards and communications are comprehensive.”

The report states that Castle Craig demonstrated:

“Clear and decisive leadership and assurance structures were in place, as well as a supportive approach for patients and staff. A coronavirus response management group had been set up to co-ordinate a hospital-wide response to the pandemic. The risks from COVID-19 had been thoroughly considered and clear actions were being taken to minimise the risk of transmission. The hospital’s quality management system was accredited to internationally recognised standards.”

About our covid-secure admissions procedure, the regulator stated:

“Patients received a comprehensive risk assessment for COVID-19 before being admitted for treatment. Patient care records were clear and included COVID-19 information in relation to pre-treatment assessment. Consent for sharing information with other relevant medical staff was clearly recorded.”

“This inspection resulted in no requirements and recommendations.”

Healthcare Improvement Scotland inspects, monitors and regulates healthcare services in Scotland to make sure they meet standards of quality and safety. They publish their findings, including performance ratings to assist people in choosing a healthcare provider and ensure quality standards are maintained. Inspections were formerlly run by the Care Quality Commission (CQC) in Scotland, now the CQC only regulates hospitals in England and Wales.

You can read the full Castle Craig HIS Inspection Report here. 

8 Reasons why online gambling is more addictive than casino gambling

In 1996 the first ever real stakes online casino was launched. Now there are thousands of gambling sites, and millions of  gamblers place their bets and participate in the world of online gambling. 

It might seem like harmless fun to start with, but Sheldon Adelson, Chairman and CEO of Las Vegas Sands Corp., the largest bricks and mortar casino operating company in the world, describes online gambling as ‘fools gold’ and ‘a societal train wreck waiting to happen’. The ‘Richest Man in Vegas’ may have a vested interest in attacking online gambling, but he might just be right. 

So what’s the truth? Is online gambling more addictive and consequently, more dangerous than casino gambling?

The diagnostic criteria for problem gambling are the same, whether it is done online or offline. The DSM­5 Diagnostic Criteria (the American Psychiatric Association’s Manual for Assessment and Diagnosis of Mental Disorders), cites the following as signs of Gambling Disorder: 

  • persistent and recurrent problematic gambling behaviour leading to clinically significant impairment or distress;
  • a need to gamble with increasing amounts of money in order to achieve the desired excitement; 
  • restless or irritable when attempting to cut down or stop gambling; has made repeated unsuccessful efforts to control, cut back, or stop gambling; 
  • preoccupation with gambling; often gambles when feeling distressed; 
  • often chases losses; 
  • lies to conceal the extent of involvement with gambling;
  • has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling; 
  • and/or relies on others to provide money to relieve desperate financial situations caused by gambling.

These criteria apply for online gambling or in-person gambling addictions. This is not surprising given that the behaviours – risk taking, repetition and escape from reality are similar. They do not, however, address the fact that the dangers of online gambling are very much greater than casino gambling. Here are  8 reasons why online gambling is more dangerous than casino gambling:


8 Reasons why online gambling is more addictive than casino gambling


1. Online gambling is available 24/7

There is endless opportunity to gamble online. With no opening hours to worry about, and noID checks, anyone can gamble online at any time of the day or night, no matter who or where they are. It feels easy and convenient to do so, and as a result there is often less of a sense that it could become a problem.

2. Gambling online can be undetected

If you’re visiting a casino or betting shop multiple times a day, friends, family, and colleagues will start to notice. It will be taking you away from work and relationships, and become very obvious where you are focusing time and priorities. In contrast, it’s much easier to participate in online gambling without it initially becoming disruptive to your lifestyle.As a result, it can seem less of a problem and you can ‘fly under the radar’. Online gambling makes it much harder for others to tell how much time and money someone is spending on gambling, so it is less easy to identify a problem and offer support. Some surveys have found that compared to those who visit physical casinos, online problem gamblers are significantly less likely to have sought formal help.

 3. It’s easy to access

Because people don’t have to physically enter a gambling venue to be able to place a bet or gamble, that barrier to participation has been removed. It doesn’t take up additional time, and there’s little physical effort to be made. You simply log on via  your phone or computer, and you can gamble. Your device becomes the casino, and it’s always in your pocket and ready to be played. A study of the popularity of online gambling by Wood et al. (2007) said that the convenience, comfort and ease of internet gambling are major factors that make it so compelling.

 4. Online gambling lures you in

Online gambling platforms tempt gamblers to  come back for more, through the use of promotions and incentives, such as free bets to newcomers. Many gambling websites offer practice or demo sessions where a person can take part in the gambling activity for free, and practise without staking any money. The odds are sometimes lowered, and most of the time, the gambler will win. They get that dopamine hit, feel confident, and decide to take part more, as the thrill of winning is compelling and satisfying.

Smart Phones are with people all the time

5. Online gambling is controlled by robots

Once newcomers have signed up, the complex algorithms that give the house the advantage kick in, and the chances of winning are vastly diminished. But by this point the gambler is invested, and hooked. Of course, in casino gambling the odds are also in favour of the house, but the difference with online gambling is that you are playing against a ‘bot’ or robot, so the game is often rigged in subtle ways. 

6. It doesn’t involve cash

When you gamble in a casino you tend to use cash. But online, you simply add a credit card and keep charging payments to it. Without the physical presence of notes and coins, it can be easy to ignore what you are spending. The losses won’t seem so great. This means that it is easier to lose large sums of money very quickly, and not really register.

Gambling in itself is a major problem, but so are the associated problems of debt, job loss, and other addictions that come with it. Many online gambling sites also allow people to bet just a few pennies to start with, which can lure them in, before they start spending bigger amounts.

On the internet, bets are often smaller and may thus seem far more affordable than gambling at a casino, but the amounts being bet can quickly accumulate. It just takes a click to access a bank account or credit cards, making it much easier to chase losses and bet on impulse.

 7. Online gambling is anonymous

Casinos have age limit laws, and in some places will not let someone who is overly intoxicated place a bet. Internet gambling sites provide little in the way of gatekeeping. Online it’s easier for someone to set up an account and avatar, lie about their age, and start gambling.

As well as being able to have a fake profile, you’re not engaging with real people, and no one sees you. This might mean that the shame which comes from regular gambling in person will be diminished. Being in a ‘disinhibited environment’ can mean that more money is gambled. It’s also a way for vulnerable individuals to participate in something they may already have an issue with, but go undetected.

Problem gamblers who have voluntarily excluded themselves from physical casinos, are likely to be able to gain access to gambling via the internet, if they so wish.

8. Online gambling builds on psychological cues

Like video games, online gambling sites use clever techniques to appeal to gamblers. There are increased levels of gratification compared to casino gambling, using tricks that trigger instincts of competition, motivation, exploration, and curiosity. Whether it’s bright lights or complex feedback loops, they use psychological cues to attract online gamblers and keep them coming back for more.

Any form of gambling can be dangerous when it becomes a compulsion and addiction. Gambling addiction goes far beyond having a flutter and placing a few bets; it often results in a breakdown of health, relationships, and jobs. Suicide rates for gamblers are higher than for any other addiction.

Online gambling offers a different experience to casino gambling due to its accessibility, anonymity, and under-the-radar approach. Combine that with the seductive manipulation produced by sophisticated algorithms, and the result is a highly dangerous activity that has dire consequences for many.

Unfortunately for the many people who become addicted, it seems online gambling is here to stay, especially in the US and Europe.

More regulation and education from Governments would help but this will do little to help those who are already addicted.

You might like to read:


This article has been approved by Chris Burn, MA, Addiction Recovery Consultant and Author of Poetry Changes Lives and The Fun We Had.
Chris Burn MA, Addiction Recovery Consultant

8 Reasons to Spend Christmas in Rehab

Would you believe it if we said that Christmas is the perfect time of year to leave your family behind, forget the parties and gatherings and Christmas shopping, and Christmas markets and go to residential rehab? With Christmas being a nostalgic time of year steeped in tradition, spending the Christmas season in residential rehab to get sober and leave alcohol behind doesn’t exactly spell “festive” by many people’s standards.

However, if you’re struggling with alcohol, drugs, or any type of addiction, it could be the best time of year for you to go for rehab treatment. Not only will you give yourself an opportunity to escape a trigger-filled environment but you create an opportunity to get ahead on your New Year’s resolutions and begin the new year with a fresh start.

8 Reasons to Spend Christmas in Alcohol Rehab

If you’ve been considering going to a residential rehab to treat your drinking problem there are many reasons why the end of the year is the best time to start. So, let’s look at some of the benefits of doing so and what Christmas at rehab can look like for you.

1. It’s NOT the Most Wonderful Time of the Year

Let’s be honest – Christmas isn’t always as magical as we imagine it to be. In fact, Christmas and family gatherings can be the most stressful time of the year for many. More so, if you’re struggling with addiction.

Being around family might not necessarily feel like a good thing. Unstable family relations and a chaotic home environment can also be a factor in your drinking or drug misuse. Or it may be that your loved-ones are concerned and fearful for your wellbeing, or just fed up with your behaviours, and you feel that they are going to judge you for not having got your life back on track.

For many, Christmas has bad connotations, perhaps a loved one died around the Christmas season, perhaps an abusive episode took place, perhaps Christmas as a child had bad memories, all of these can feel like a reason to hide away from Christmas at the bottom of a bottle.

So while rehab at Christmas doesn’t immediately sound like a way to celebrate the occasion, ask yourself if the alternative is better – a Christmas at the bottom of a bottle or passed out on your sofa. And know that most patients that have found themselves in treatment during this time feel that they definitely did not regret their decision.

2. No Need to Be Alone

If you happen not to have family or friends to spend the holidays with, Christmas can make you feel abandoned and alone – especially when you see others appearing to have a great time. That in itself can be a major trigger for people who tend to misuse drugs or alcohol.

At a residential rehab, you are guaranteed to be surrounded by people who can relate to your struggles. Not to mention the numerous supportive staff who are passionate about helping you design a better life.

3. You Can Get Away from It All

There’s hardly ever a holiday party that doesn’t involve alcohol. Drugs, too, can be more accessible than ever. Not to mention casinos and office parties with colleagues, neighbourhood Christmas gatherings where nearly everywhere you turn there is the offer of a “warming drink” or a toast at a party. If you’re struggling with alcohol addiction it feels like the only safe option is to stay at home away from everyone.

At a residential rehab, you will be guaranteed a safe space where you won’t be tempted by anyone or anything. There won’t be a family member around asking if you’d like a drink nor will you be tempted when watching others making toasts with alcoholic drinks.  You’ll be living in an environment that is free from temptation, where you are able to focus on your needs, not what others are doing or expecting of you.

4. The Most Precious Gift of All

Being free from addiction is arguably the best Christmas gift you can give to both yourself and your loved ones. The feeling of freedom that comes with being sober is a present that no money can buy.

Your family and friends will appreciate this too, as addiction can take quite a toll on them as well as yourself. If you know you tend to wreak havoc over the holiday season, perhaps the best decision you can make is to take a break from it all.

But ultimately, you have to put yourself first. By starting treatment before the holidays, you can begin the New Year with a fresh and clean start.

5. Get Treatment in a More Intimate Environment

Residential rehabs tend to be at their most quiet around the holidays. And that’s not a bad thing at all! Actually, the period around Christmas tends to be the best time to start treatment as capacity is lower while the number of staff remains the same. In other words, that means a higher staff-to-patient ratio, meaning you, as a client, get more individual attention and better help.

Most residential rehab centres, including Castle Craig, are open 24 hours a day, 365 days a year. Unlike many institutions, addiction treatment facilities and their staff do not take days off. Don’t think that going during the holiday season means you’ll be alone or ignored — it’s quite the opposite.

6. Avoid the Crowds

On the other hand, waiting until January tends to result in the opposite. Residential rehabs tend to be at their peak capacity at the start of the year. Why? Far too many people wait until New Year’s to begin their resolutions.

Of course, private rehabs such as Castle Craig always limit their patient numbers throughout the year to assure that every patient gets attentive care — especially in times of COVID-19. However, I think we can all agree that when it comes to addiction treatment, it’s better to have the staff focused on only a few vs. many.


7. Use Up Your Workplace Holiday Allowance

If you have put off going to rehab because you can’t take more than two weeks off work, it might be that you have managed to save up enough time to take longer off, alongside the bank holidays around this time of year, it can be ideal to fit in three or even four weeks away at rehab.

8. What Will You Miss?

Think about your recent Christmases. Sure, everyone has great memories of this or that, but if your addiction overshadowed the good, it can be a painful time to look back on. Take Amanda, for example. Recalling her last holiday with her family, she feels shame that Christmas brought out the worst in her:

“I think back to my last Christmas and am filled with shame and regret. I drank two bottles of wine on Christmas Eve and didn’t get up until noon on Christmas Day, missing the church service and arriving late for the family celebrations. 

During Christmas dinner, I drank several glasses of champagne until my parents asked me to stop, at which point I got angry and started an argument about my drinking. I stormed out of the house and drove home, lucky not to get stopped by the police as I was well over the drink driving limit.”

If, like Amanda, you think spending the holidays at home will do more harm than good, going to rehab may be the best choice to avoid another bad Christmas.

What’s Christmas at Rehab Like?

How holidays are celebrated differ from rehab to rehab, so we can’t speak for everyone. However, we can offer some insight into how Christmas looks like at Castle Craig.

Whether you celebrate Christmas or not, we believe that the holiday season is truly a special time and should be recognised in a special way.

For example, in addition to Christmas trees, we normally have a carol service, a non-alcoholic Christmas Eve drinks party, and in the past we have even had a visit from Santa and his reindeer. We also offer day trips to local churches for anyone who wishes to attend services on the day. And of course, anyone who wishes to make a phone or video call to their family and friends is more than welcome to do so.

Of course, due to the coronavirus pandemic, things may be a bit different this year. But regardless of restrictive regulations, we assure all our patients that they will have a happy and unforgettable holiday.

What have our patients said about Christmas at Castle Craig? (Quotes from our Facebook page)

I got to spend Christmas at CC in 2016 and it will go down as one of the best Christmases of my life ? and New Years Eve in ECU was just amazing! Never ever did I imagine I’d do karaoke without a drink ? the holidays alone taught me so much x – Ashleigh

I spent cristmass 2001 in there. It was great the groundsman had a sliegh he brought up dressed as santa – David

Xmas 2007 in CC was close to heaven! – Floris

I spent Christmas 2006 in there and I know that if it wasn’t for Casle Craig staff and community I would not be alive today xxx Eternally grateful xxxxx – Elaine

Arrange a Christmas Rehab Retreat With Castle Craig

If you believe spending the holidays with us is the best option for you, don’t hesitate and call us today to secure your spot. Our residential packages provide all patients with comfortable and cosy ensuite accommodations and access to our public facilities such as a lounge room with a fireplace, a well-equipped fitness centre, and peaceful private walking trails.

Feel free to contact us today by phone or email at 0808 274 6351 or, respectively. We’ll be happy to answer any questions you may have and arrange for a stay as soon as possible.

How are we performing? Recent patient satisfaction levels

We regularly run audits on patient satisfaction levels to make sure we are listening and responding to what our patients are saying. Recent surveys taken in July and September found the following:

Our patients describe our staff as ‘very kind’, ‘supportive’, ‘diligent’, ‘fantastic’, ‘absolute treasures’, ‘rays of sunshine’ and ‘efficient’.

Every category rated 100% Good, Very Good or Excellent, with particular praise for nursing care, individual therapist care and staff support.

Ratings increased to Very Good or Excellent for ‘Catering’ (88%), ‘Accommodation’ (89%), for ‘Fitness’ (89%).

New fields for ‘Use of ICT’ and ‘Hygiene, Health & Safety and Infection Control’ were very positively received.

Our patients asked for improved technology for virtual meetings and a smoother transfer process, and these are have been provided.

100% of our patients feel that they are treated with dignity and respect.

Infection Control

We have conducted four audits in the last two months, for Recovery Gardens (99.12% compliance), the Castle (96.5% compliance), Kirkurd (95.2% compliance) and for the Fitness and Massage Suites.

We have completed all the immediate action points for these to ensure the safety of both our patients and staff. 


In memory of Father Hugh Purcell

Everyone at Castle Craig was deeply saddened to learn of the death of Father Hugh Purcell, who recently died suddenly at St John Vianney’s parish house in Gilmerton at the age of 62.

Father Hugh had a long relationship with Castle Craig; for many years he was our pastoral counsellor, helping many patients into recovery. He spoke openly of his addiction issues and our patients and staff loved his warmth, his spirit, and his down-to-earth nature.

An obituary can be read on the Archdiocese of St Andrews & Edinburgh website, while some of the team at Castle Craig have said the comments below.

Father Hugh Purcell with members of the Castle Craig team

Dr Margaret Ann McCann, CEO and Co-Founder of Castle Craig:

“We will greatly miss him and feel the loss of his joyful spirit and sense of humour. Despite the many demands upon him as a busy parish priest he carved out time to visit weekly at Castle Craig, for many years, in order to provide pastoral care to our patients, often travelling a considerable distance – so great was his dedicated commitment to those suffering from addiction and his enthusiasm to impart the Message of Recovery.”

“We will always be grateful for his kindness, compassion , generosity and unselfishness which marked him out in a singular manner.  We are grateful to have known him and Let Go with Love and gratitude to our Higher Power.”

“What You give, You take not away, for what is Yours is ours also if we are Yours.
“And life is eternal, and love is immortal, and death is only a horizon,
“and a horizon is nothing, save the limit of our sight.”

Guy Heath, Senior Staff Nurse at Castle Craig:

“Patients loved him. He could really talk their language, he was very down to earth, and committed to helping people as much as he could.”

Gordon Hogg, Therapist at Castle Craig:

“Father Hugh had a long relationship with Castle Craig and for many years was our pastoral counsellor. His warmth and passion for recovery and life would embrace you from the moment he came into your life. He was well loved by the patients and I am sure influential in their recoveries.

“I had the pleasure to be present when Hugh was ordained. It seems like yesterday, a joyful and happy day made even more poignant by the journey he had taken to get there. He was surrounded by all who loved him and his fellow priests in the Diocese.

“Father Hugh had a common touch which endeared him to all and he made himself available to any who crossed his path. He was full of sound wisdom, which he dispensed with little effort and lots of passion.

“His other passion in life – and indeed it was a passion – was for fishing. To be with Hugh when he was fly fishing was to be taken to another dimension. He tried to entice me into the joys of fly fishing at Threipmuir Reservoir up in the Pentland Hills one day with little success, however I did experience the joy it gave Hugh. He was generous with his catches and many an evening I enjoyed a lovely fresh brown trout that Hugh had caught and of course accompanied by the tale of its catching.

“I will miss you Father Hugh. Rest in peace.”

Father Hugh Purcell Card

Royal College of Psychiatrists show drinking has nearly doubled since lockdown

High-risk drinking has nearly doubled since lockdown, reports the Royal College of Psychiatrists, and addiction services are in desperate need of funding. Castle Craig’s data supports this, with website visitors more than doubling, a record number of daily enquiries to our Help Desk, and a rising number of enquiries about the Castle Telehealth online addiction therapy programme.

The Royal College of Psychiatrists today issued a statement after analysing data from Public Health England which shows that the rate of people in England drinking “high risk” amounts of alcohol has almost doubled at 19% in June, up from 10.8% in February 2020. They called for more funding from the government for addiction services in the UK.

Reflecting these findings, the number of people looking into addiction and addiction help on the Castle Craig website from June – September 2020 was more than double the number who did the same a year ago (an increase of 118.6%), with this rate increasing week-by-week. There has been a resultant increase in daily enquiries about residential addiction help as well as teletherapy – remote treatment for addiction which people can complete from their home – which has become an increasing popular way to treat addiction problems.

NHS guidelines advise people drink no more than 14 units of alcohol (equivalent to six large glasses of wine or six pints of beer) a week, spreading consumption over three days or more.

UK news outlets today are reporting the warning from The Royal College of Psychiatrists that many more people are drinking large amounts of alcohol since lockdown. Addiction clinics and services in England could struggle to cope with “soaring” numbers of people misusing alcohol. 

Drinking too much can lead to addiction and damage your liver as well as increasing the risk of other health conditions such as heart disease and stroke. These medical complications also increase the risk of further complications if a person should catch coronavirus.

The Royal College of Psychiatrists says that deep cuts made to addiction services could mean patients will miss out on life-saving care.

Dr Adrian James, president of the Royal College of Psychiatrists is quoted in The Guardian saying that “Addiction services have been starved of funding in recent years meaning many are not able to treat and care for the huge numbers of people who are drinking at high risk.”

Victoria McCann, Senior Communications Manager at Castle Craig has said that “NHS referrals to residential rehab in Scotland are at an all time low. Castle Craig’s own admissions figures show that in 2019 only 5 patients were granted funding from the NHS. Our enquiries at Castle Craig are at an all time high and we currently have a waiting list. More is needed to be done to get people the help they desperately need at this time.”

Castle Craig currently has a waiting list of patients, partly due to restrictions on the amount of patients we can admit weekly due to our Coronavirus prevention measures which include a specially dedicated admissions unit and a social distancing policy. We are Covid-19 free and have been admitting patients during the Coronavirus pandemic. 

How Has 12 Step Recovery Helped You Prepare for the Coronavirus Pandemic?

In recovery we remember the isolation our addiction brought us to, so we knew what isolation meant and how it felt. In 2020, that’s something which has been new for a lot of people – especially family members of those with addiction – they didn’t understand what it meant when we talked about those feelings of isolation. Now they’re really realising what that is and what that does to you.

Most important of these is Step 1. 

Step 1 – Admitted we were powerless and our lives were unmanageable

In terms of global issues that are facing us, Step 1 helps us be able to recognise the unmanageability that’s happening on a global scale, and that we are individually powerless over the virus.

When you’re in healthy recovery, Step 1 is about realising that life can be unmanageable and there are things that we are powerless over and so, in terms of addiction recovery, recognising how addiction has made your life unmanageable, and that you’re powerless over your addiction. 

“We can’t control the pandemic, and we have to kind of accept that this is where we’re at. And if you’re in healthy recovery you have a very good grounding in Step 1, so being able to acknowledge that this is chaotic and unmanageable at times, that we can accept “this is where we are” and we can begin to work with things as they are for us each day.”

Step 2 – Came to believe that a power greater than ourselves could restore us to sanity

Power: Self-awareness

The term ”isolation’ has negative connotations, but it is possible to use time away from other people as a chance for increasing self-awareness. Learn to sit with yourself and learning to take advantage of these moments for self-growth and self-exploration.

“Self-awareness is a key cornerstone to getting well and so figuring out how you are feeling and how you are responding is important.”

Recovery and the 12 Steps teach us how to connect with other people and how to ask for help when we need it.

8 key tips for self-awareness during lockdown:

  • Talk about what’s on your mind,
  • Talk about how you are feeling,
  • Think about what is important to you and what you value,
  • Remember One Day at a Time,
  • Think about your loved ones who are in lockdown or afraid to leave the house and connect with them to let them know you care,
  • Keep connected to your recovery community via whatsapp and social media,
  • Remember you have asked for help before and you can do it again if you need to – no one will judge you! 

One Day at a Time

Focus on the present. Practise Mindfulness to keep you in the here and now. Don’t worry about what is going on in the outside world, focus on yourself and your self-exploration. You cannot change the past, don’t dwell on it; and you cannot know what is round the corner, don’t be anxious about it; but in the here and now you can find peace and contentment.

Using technology to bring us together

We forget that we’re social creatures by nature – that’s part of being human – and technology for so long had become a barrier for that. With this we’re learning to bridge that gap and realise that actually we don’t have to use technology to isolate ourselves, we’re trying to see how we can turn that around. 

We all need to keep reaching out to people, keep talking and keep sharing. There are people who will understand.

Therapy sessions and medical consultations have moved online. The newly launched Castle Telehealth programme has allowed people to connect with our therapists online, providing therapy in their own home and mitigating feelings of anxiety and isolation which can lead to increased drinking during lockdown. 

“Being able to connect to the online programme and take active part in sessions, groups and workshop allowed me to feel less isolated during lockdown.” – A Castle Telehealth patient

How has the recovery community responded to the Coronavirus Pandemic?

The recovery community did an amazing job of when we weren’t able to do face-to-face meetings any more. Groups began reaching out to each other, they began doing larger platforms to continue to hold their meetings, so that they were still coming together on a regular basis to support each other. 

Smaller groups of friends in recovery made smaller WhatsApp and Zoom groups, again to maintain that recovery and that reaching out to people in a time of need and to get that support that need.

The Castle Craig aftercare group has gone digital, so people that have been in treatment here that were physically attending our aftercare programme here at the Castle have gone digital, and it’s actually allowed it to expand so that some of the folks who weren’t in the area and able to get to the meetings on campus now actually get to participate and connect with peers that they were in treatment with.

I’ve done the family workshop, which is typically in person, I did that digitally this past month, which was an interesting format but still successful and helpful and so it is part of considering in what I do. Nothing replaces a face-to-face meeting – as we all know – there’s an energy that you get from being in a room with other people, but at the same time there’s a lot to be gained from still feeling that connection and hearing each other’s stories and sharing that connection.

Interview with Teri Lyn Fairnie, MSc, Lead Family Therapist at Castle Craig.



Coronavirus presents a new challenge to sobriety

Addiction sufferers and their families face new challenges.  Coronavirus increases the dangers faced in recovery and has also adversely affected some well-tried responses which, until now, have proved reliable.

The sudden arrival of coronavirus has brought everyone out of their comfort zones. Stress levels are high, mainly due to fear of the disease itself. There is also fear of consequences such as financial meltdown. Throughout the UK and around the world people are anxious, afraid and wondering what to do about it all.  We are being told to self-isolate and distance ourselves socially and none of this is good news for anyone, including those suffering from addiction.

Many groups of people are having to adjust to new ways of doing things and those who suffer from addiction – or have been affected by the addiction of others – are certainly one such group. Those suffer from addiction will recognise the feelings of anxiety, fear and uncertainty that these events are producing. After all, addiction is also a pandemic that has been around a long time and has killed a lot of people.

Alcoholics Anonymous – and its many 12 step derivatives such as Narcotics Anonymous and Gamblers Anonymous – are perhaps the most successful response to addiction ever devised. For them, recovery comes through human interaction first and foremost and a popular slogan is ‘You are no longer alone,’ with newcomers often attending 90 meetings in 90 days.  Longstanding AA members support their local meetings with a fervour and regularity that many churchgoers only aspire to.

But now, the recent government advice to self-isolate and distance means a very careful rethink to the way that these self-help groups are run. After all, self-isolation does not sit well with a movement whose cornerstone is human interaction. Old habits are changing, and old methods are being reviewed.

Nevertheless, those in recovery should not panic. AA members know from the marvellous Serenity Prayer that although they cannot change events, they can certainly change themselves. And in times like these, necessary personal changes can – and need to – happen. Headlines such as: ‘Coronavirus lockdowns could see thousands of alcoholics relapse as Alcoholics Anonymous in-person meetings shut’ are alarming and often untrue.

Will virtual meetings replace real AA and NA meetings for good?

Some members are worried that virtual meetings will permanently replace actual meetings. It might at first glance seem an easy substitution but, for AA and NA newcomers especially, there is a special power in the warm handshake of welcome, the cup of tea and the holding of hands while the Serenity Prayer is recited at the conclusion of a meeting, which can make all the difference between success and failure.

Can all this be replaced? There are certainly the tools to try – besides virtual meetings, there is a wealth of groups on Facebook, WhatsApp, Skype, Zoom and the “old-fashioned” telephone. With these, it would seem communication itself is not the problem. Some might say connection is all that matters while others may feel that physical presence and warmth are crucial.

Progress is not perfection

Nevertheless, when forced to – by government directives and the desire to help those who are vulnerable – we are all having to learn some new ways; we may be powerless to change many things but we do have the power to learn. We can learn to adapt and to see virtual meetings and contacts as representing a form of ‘progress not perfection’ – another popular AA slogan.

An AA old timer said to me recently ‘AA started when two hopeless alcoholics met and realised that by talking together, they could stay sober. Would it have happened if their meeting had been on Skype? We will never know, so let’s be grateful for what we have.‘

At times of stress and challenge, it can be useful for those of us in recovery to remember our priorities, evaluate our resources and perhaps revisit our core beliefs and attitudes. Here are some general points for consideration.

The disease of addiction

Coronavirus is a major threat to public health, but addiction is a serious and life-threatening disease too. We should take care that the steps we take to defeat coronavirus does not endanger our recovery addiction.

Self-isolation, not social isolation

Self-isolation is crucial but addiction itself is a disease of isolation and many addicts have led lonely lives. Therefore, when self-isolating from coronavirus you must stay connected to your own support network – sponsor, therapist, the fellowships and your family and friends.  We are lucky today that technology makes this easy to achieve.

Think rationally

The present crisis feels serious because it is serious. But we should not let our feelings get out of hand. Remember that our feelings are connected to our thoughts and our beliefs. Therefore, it is important to think rationally.

Every situation can be managed and overcome, but this depends on our responses. Catastrophising simply does not help. We have come a long way from the primitive choices of freeze, flight or fight. Civilisation has evolved because we have learnt to develop better responses than these.

Avoid the “Breaking News” loop

Remember in this respect the dangers around too much media exposure. The TV and other outlets nowadays often produce a constant stream of breaking news – much of it bad and often sensationalised – which in itself can become addictive.

Those in recovery should remind themselves of the inherent dangers in becoming a ‘news junkie’ and recognise how breaking news can provide an unhealthy buzz of excitement and escape that characterises many addictions. We should ration our exposure to live news so as to keep our thinking healthy.

Respect family members

Family members are always important for addiction recovery. Addiction is a family disease and family members should take the same approach towards their support group meetings of Families Anonymous and the like, as their addicted loved ones. Equally importantly, consideration should be given to the constraints and frustrations that will surely arise when social distancing and self-isolation cease being novelties and become irksome burdens instead. Try to be aware of each other’s concerns and to respect their needs.

Recovery planning

Whatever stage of recovery you are at, there should always be an underlying plan, whether you are aware of it or not. This is true whether your sobriety covers years or simply a few days. Recovery is always important because addiction is never beaten completely, only contained. Your recovery plan, whether formalised in a document or simply established through good habit, has to address your basic needs:

  • Be with the right people
  • Avoid dangerous situations
  • Connect with your higher power
  • Help others

In normal times these needs would be met through attending fellowship meetings, which is largely what many people in recovery manage on a weekly basis. In these abnormal times we need to adjust.

And we still need to connect, in as human a way as possible. Even when meetings are closed, because of the infection, in some cases AA members will turn up, lest a desperate person comes, needing help. This AA member in the USA puts it well:

Tonight, we’re still gonna be there….a representative needs to be there, maybe not to shake their hand or give them a hug, but at least give them a phone number. Let them know they’re not alone.”

Addiction is a disease of isolation and addicts can be lonely people. Reaching out, even if not actually touching, remains vitally important for recovery.

A word of hope

Great problems have been solved before. Disease epidemics have been addressed and made manageable in the past and coronavirus is no different. Our response as people in recovery should be to accept and adapt, making changes wherever possible. The world will recover. To quote yet another favourite AA slogan:

‘This too shall pass’.

Written by Chris Burn, Addiction Recovery Consultant and Writer. Former therapist at Castle Craig Hospital.

Half a lifetime helping addiction recovery – Peter McCann celebrates 80th birthday

Almost 40 years ago, Peter McCann and his wife, Dr Margaret Ann McCann, began helping people with drug and alcohol addiction into a life of recovery.  This eventually led to the founding of Castle Craig Hospital in 1988. As he celebrates his 80th birthday having spent half of his lifetime helping people overcome addiction, we asked Peter to look back on his own life, and the changing face of addiction treatment.

A genuine understanding of addiction

Peter’s passion for helping people overcome addiction came from his own experience, along with coming from a family with a medical background.

“It was from my own recovery – and having been brought up in a professional medical family myself, I was motivated from an early age to be wanting to care for people. Not being a doctor as such, I very fortunately married a doctor and with her medical skills and my business skills and finance knowledge, the combination of the two made an ideal partnership.

“I was a bit of a playboy when I was younger, drinking a lot, so when I was younger the thoughts of recovery were totally alien to me. It took the difficulties of going through the early recovery stages in order for me to develop an insight into what was needed and how one could help that. For me that came through the involvement of Alcoholics Anonymous; I’m very fortunate in having had some very good mentors indeed there and they were very supportive.

“Two of my most important influences were my original sponsor in Alcoholics Anonymous and his wife – Trevor and Mairi Oliver. She used to run the London telephone service for AA and I used to volunteer and take the telephone there at regular times, and that was a wonderful experience because I was talking to sick alcoholics on the phone and meeting up with them and taking them to meetings and that was a very useful background for me for later on in life.

“The ability to work with people – who encouraged us a lot – has been a big influence and in fact it was Mairi Oliver who introduced me to Margaret Ann, who obviously is my biggest influence.”

Scotland’s first 12 Step rehabilitation clinic

Peter and Margaret Ann founded Castle Craig five years after founding Clouds House, and realising a need to build a larger centre to treat addiction in Scotland.

“I’d been very impressed to see people coming to AA meetings who had been to treatment centres in the States and we wanted to bring those kind of treatment outcomes to the UK.”

“So we set up Clouds House and, with very very limited charitable funds we were able to get that up and running and it gradually, over a couple of years, got a very fine reputation. After four of five years there we decided we wanted to move and establish our own centre, because we were rather constrained by factors including the size of the property.

“So a choice was made to move to Scotland – where my family had originally come from – and after a lot of hunting we discovered Castle Craig, which we purchased from Strathclyde regional Council.

“The property happened to be available at the right time – ideally situated and able to be converted to a treatment centre with all the facilities, in wonderful surroundings, and close to big centres like Edinburgh and Glasgow.

“There we were – 50 acres, with an empty building and empty coach houses and other buildings on the site, and we started a room at a time – we furnished a room, filled that with patients and did the same to the next room and gradually built up a good team of staff, nurses and therapists.

“Gradually we ended up with about 120 beds – both the main clinic and what is now the extended care unit, so it has been very good indeed.”

Changes in NHS funding and expansion to Ireland

We were very fortunate – particular in the early days – to get a lot of patients from the NHS, particularly Glasgow, up until the turn of the century. It’s rather changed now – there’s more emphasis on care in the community which is regrettable, because many of the patients who came to us weren’t really suited to that.

“Now we have a complete cross-section of patients. We have patients coming from the Netherlands, insurance-funded patients, and private cases.

“We branched out and opened a clinic in Ireland – Smarmore Castle – and really did that because, knowing we were going to be leaving the European Union, I wanted to retain a foothold in the European Union, which is operating successfully”.

“We’re very fortunate in having Professor Jonathan Chick as our Medical Director – who took over from Dr McCann after she had had the position for many years. he is a world-renowned addictionologist and it’s very good to have his input here.”

How knowledge of addiction has changed in the past 40 years.

“People used to believe that when you went out on a drinking binge, you destroyed several billion brain cells and they were gone forever, but that changed about 20 years ago – that ‘accepted wisdom’ was proved to be totally wrong, and that brain cells could actually regenerate.

“You had to meet several conditions to heal your brain – the very first one of course is to stop drinking or using drugs – and then things like a good, healthy diet, lots of exercise and meditation, all the things one can get in a good residential treatment programme – are all necessary for the brain to regenerate. And that takes time – it can’t be done in five minutes.

“They used to say in AA ‘don’t make any major decisions for the first couple of years in recovery.’ They didn’t know why they said that, but the reason was through experience – people made mad decisions in their early recovery because of the brain damage, and it takes a couple of years for that to heal and rational thought to prevail.

“Really, unless those conditions can be provided in an outpatient setting – which, for many people, that’s impossible – it shows how important residential care is if there’s going to be brain recovery.

“The very latest research – just out last year – says that after someone stops drinking, the brain carries on being damaged for the next six weeks so that if someone has a short period of treatment – say four weeks, it means that you’re leaving treatment and the brain carries on being damaged and of course and that leads to a higher relapse rate. So these messages must be taken on by the treatment community – and by the people who fund the treatment community – because if you want to have a good success rate you’ve got to repair the brain, and you’ve got to have the conditions right for that.

Treating trauma and addiction together

“There are a lot of mental health issues which are there as a result of addiction and that’s why a well set up treatment centre like Castle Craig and Smarmore can handle comorbidity and dual diagnosis cases, looking at the mental health issues and the addiction issues. This should be done at the same time and in a lot of countries this isn’t – Ireland being an example – where it’s very difficult to get this joined-up treatment but which we are providing at Smarmore in Ireland, as well as Castle Craig in Scotland.

“Unfortunately at the moment [with the coronavirus pandemic] it’s very difficult to maintain services but we must manage through until this virus is conquered, because we know there is going to be a big demand because many people are very unsettled – especially those in early recovery. So very regrettably, we think a lot of people will have very serious difficulties and will be needing help in the not-too-distant future.

“In the aftermath, a lot of people will get post-traumatic stress disorder and have to be treated for their trauma, for example when they’ve had relatives dying and not being able to say goodbye to them – all these are very difficult situations.

“But if there’s an addiction issue there, of course we can help and we can treat PTSD together with addiction – we’ve got specialist therapists who can help that.

“There’s a lot of work to do.”

Thanks to the team and the treatments Peter has worked hard to build up over the years, that work can continue for many years to come. So if you’re struggling with addiction, or you know someone that is, please get in touch because – as always – we’re here to help you.

Castle Craig Extends a Lifeline for Addiction Sufferers During Lockdown

Following warnings from the World Health Organisation that people may increasingly turn to alcohol as an “unhelpful coping strategy” during the Coronavirus lockdown, Castle Craig Hospital, has restructured its intensive rehab programme into “Castle Connect” an online package to be transmitted across telehealth platforms. 

Our team of skilled psychotherapists and addiction specialists are needed more than ever by people suffering from addictions, anxiety, stress and isolation. The online rehab programme, Castle Connect, enables people to engage with specialist addiction therapists from the comfort and safety of their own home. Many people who have considered rehab in the past will be able to use the lockdown as an opportunity to get the help they need. 

Professor Jonathan Chick, Medical Director at Castle Craig, said: “The uncertainty and isolation created by current events and the lockdown is increasing anxiety for many people and, for those struggling with addiction, this anxiety may trigger a return towards alcohol, drugs or gambling. Also, with families spending increasing amounts of time together, problems with addiction which were previously hidden could become apparent. Our programme, which people can complete remotely, enables people to get the help, structure and support they need at this time.” 

Launching on Monday 13th April and already generating admission assessments, the new online therapy programme is delivered by Castle Craig’s senior addictions therapists with online face-to-face individual CBT and group therapy sessionslive educational, didactic lectures; online Covid-19 anxiety, stress & PTSD workshops; online psychiatric assessments; online reading and learning materials; online family therapy, therapist facilitated group therapyonline fitness and mindfulness sessionsonline AA and NA fellowship groups.

Dr Margaret McCann, CEO and Founder of Castle Craig, said: “For more than 30 years we’ve delivered a structured and highly successful programme which has enabled thousands of people to beat addiction to alcohol, drugs, gambling and more. With modern technology, we can help individuals and their families to beat addiction while in isolation and we are determined to continue to help as many people as possible to recovery through this very difficult time.”

Visit Castle Connect for more information.

To arrange a free assessment contact our Admissions Team.

Alcohol and Viral Immunity – Heavy Drinking Increases the Risk of Virus Infection

Excessive alcohol consumption is known to cause damage to both the physical and mental well-being, especially if consumed regularly or in large amounts. More so, it can lead to a lowered immune response, particularly when combined with stress.

Castle Craig’s Medical Director, Professor Jonathan Chick, advises that during the COVID-19 pandemic it is important to avoid regular heavy drinking and heavy drinking sessions. Reducing or ceasing heavy drinking should improve immunity within days, (except in the case of liver damage).

It is advisable to take extra precautions to keep ourselves and each other safe. As there is no known cure for the virus at the moment, the best we can do is keep our health in good shape to be able to fight it off, should we get sick. Taking care of your immune system will help you get over any viral illness quicker. Reducing, or better yet, eliminating alcohol intake can have a significant impact.

Does Excessive Drinking Weaken the Immune System?

Weakening the immune system is one of many negative effects heavy alcohol consumption has on the body. The mechanism is not fully understood and other factors such as age, gender, diet, state of general health may play a part.

Some studies have shown that, in moderation, certain alcoholic beverages such as wine and beer can actually decrease inflammation in the body. But at the same time, other studies suggest that even moderate consumption can do damage.

One drink has negligible effects on the immune system response, but three drinks or more has significant effects. At intoxication levels, the immune system begins to function very poorly.

Chronic, heavy drinking has been proven to lower the body’s ability to fight off infections. Long-term, excessive alcohol consumption has a lasting effect on the immune system. Even one episode of binge-drinking can cause mild damage. 

How High Alcohol Consumption Influences the Immune Response

Firstly, alcohol decreases the ability of your white cells (which fight off infections) to function properly. Heavy drinking can worsen this, as can other alcohol-related conditions, such as liver disease.

Secondly, alcohol tends to damage the digestive system, which includes the gut microflora. Any increase in inflammation in the body, from alcohol or otherwise, can kill off the good bacteria. This is not good, as it helps us digest food and absorb nutrients. The well-being of our digestive system is directly tied to our immune response. So, any changes in our digestive tract also change our ability to fight off viral and bacterial infections.

Thirdly, alcohol is known to damage the cells in your intestines, which can lead to malnutrition. We all know that a poor diet or lack of nutrients can wreak havoc on one’s health, especially the immune system.

And lastly, alcohol may also affect the lungs’ immune system, making one more prone to respiratory infections such as pneumonia and COVID-19. This can also be worsened if the person is a smoker.

Professor Jonathan Chick, Medical Director at Castle Craig Hospital says:

“Heavy drinkers have lower immunity to viral and bacterial infections than abstainers or light drinkers. This is particularly when the liver has been damaged by alcohol. Specific research on immunity to corona-type virus infection and alcohol has not been published yet, but a likely added protective factor in the current COVID-19 epidemic is to avoid regular heavy drinking and heavy drinking sessions. Reducing or ceasing heavy drinking will probably improve immunity within days, although if the liver is damaged this improvement would be much slower.”

Alcohol and the Coronavirus

Since the coronavirus (or COVID-19) is a novel development, there is no research specifically tied to the virus and alcohol consumption. However, since COVID-19 is a type of the coronavirus family, the same as the common cold and multiple respiratory diseases, it is reasonable to presume that the same rules apply.

Because heavy drinking lowers the immune system and can worsen the lungs’ health, it is advisable to cut down on alcohol consumption during a viral respiratory pandemic. Heavy drinking not only makes you more susceptible to getting the infection, but also makes it harder for your immune system to fight it off.

Aside from alcohol’s direct effects on the body, keep in mind that alcohol also affects judgement. This means you’re less likely to follow rules or basic hygiene, you might not eat as healthily (thus, leading to poor nutrition), and you are more likely to engage in other risky activities, all of which can increase your chances of getting sick.

The European arm of the World Health Organization (WHO) recently said relying on alcohol to alleviate stress and anxiety is an ‘unhelpful coping strategy’.

WARNING: Alcohol is NOT a Cure for COVID-19

If you have heard that alcohol kills the coronavirus, understand that this refers to alcohol-based hand sanitiser – which is not made for human consumption. Drinking any type of alcohol will not help to prevent or cure the coronavirus. Only 60%+ alcohol, which is far above most beverage alcohols, can destroy the virus and only on surfaces. Since alcoholic beverages are normally 40% ABV or less, they are technically not suitable even as a disinfectant.

How Long Does It Take for the Immune System to Recover if You Drink Heavily?

If you’re a regular drinker and stop altogether, your immune system will generally start to improve within a few days. It can take a week or more, however, if you have other underlying conditions, such as liver damage. The longer you have been drinking, the longer it may take to get back to normal. A full recovery will take time and ongoing sobriety.

If you normally don’t drink and engage in one binge-drinking session, your immune system is likely to be suppressed from a few hours to a day. Again, it depends on your overall well-being.

Please keep in mind that if you have been regularly drinking in significant amounts, stopping cold-turkey can be dangerous as well. Should you find that you have trouble quitting drinking, you can call Castle Craig on 01721 722763 for advice.

What Underlying Health Conditions Can Alcohol Affect?

In addition to immune suppression, alcohol can lead to, or worsen to a number of physical health issues and other bacterial and viral infections including:

  • Pneumonia
  • ARDS (acute respiratory distress syndromes)
  • Liver disease
  • Pancreatitis
  • Diabetes
  • High blood pressure
  • Cardiovascular diseases
  • Leaky gut syndrome
  • Cancer
  • Ulcers
  • HIV
  • Hepatitis B, C

It’s been reported that people who have the hardest time recovering from the coronavirus are ones with underlying conditions, some of which are mentioned above. Hence, if you are concerned about the coronavirus, it is best to reduce or abstain from alcohol for the time being. You’ll be doing your body a favour!

Treatment for Those Worried About the Coronavirus Who Can’t Stop Drinking

If you would like more details on Castle Craig’s innovative online addiction therapy programme contact us on 01721 722763 or for more information.

If you are worried about COVID-19, now is the best time to cut down or quit drinking. You can think of it as a re-do of Dry January. Of course, alcohol isn’t always easy to give up, so you might need some additional help to go through with it. It doesn’t mean that you have a problem, but having a hard time trying to stop is usually a sign of some sort of dependency. It’s best not to keep bottles in your kitchen cupboards as a starting point.

Seek Self-Help

The first line of advice, when it comes to addressing problematic drinking, is to attend an Alcoholics Anonymous (AA) meeting or pay a visit to an addiction rehab clinic. However, with the government now urging everyone to stay at home, most meetings have gone online, and other centres may be harder to access.

Fortunately, AA has not closed its doors, despite cancelling its meetings. You can refer to their coronavirus news page for how to get in touch about a virtual meeting near you. There is also a directory of global online and telephone meetings at the AA Online Intergroup website.

You can also visit In The Rooms, which is a new online recovery meeting network.

Castle Craig’s newly launched online addiction therapy programme offers four weeks as a ‘digital outpatient’ and is an innovative way of battling addiction while at home.

Online Addiction Treatment During COVID-19 at Castle Craig Hospital

Castle Craig Hospital is a private residential rehab centre specialising in alcohol and drug addiction. Our therapists are experts in their field.

We understand these are difficult times, but we promise that we will always be there for you.

If you would like more details on Castle Craig’s innovative online addiction therapy programme contact us on 01721 722763 or for more information.


Prog Neuropsychopharmacol Biol Psychiatry. 2016 Feb 4;65:242-51. doi: 10.1016/j.pnpbp.2015.09.001. Epub 2015 Sep 14. Opposing effects of alcohol on the immune system. Barr T1, Helms C2, Grant K2, Messaoudi I3.

Alcohol Res. 2015;37(2):159-70. Alcohol’s Effect on Host Defense. Szabo G1, Saha B1.


New Admissions Unit Opens at Castle Craig to Meet the Challenges of the Coronavirus Pandemic

This blog article is not updated. For our latest Covid-19 Preparedness & Response Updates please visit our page

In response to the Coronavirus pandemic, Castle Craig rehab clinic has launched an innovative, separate admissions and detox unit to treat drug and alcohol addictions.

The separate admissions unit, Kirkurd Unit, was created in response to the unprecedented Coronavirus pandemic and the increased demand on NHS resources and closure of Private and NHS detox beds and rehab clinics around the UK.

The Kirkurd Unit strives for enhanced Covid-19 screening at all stages of admission and detox and a 7 day social distancing period before admission to the main clinic of Castle Craig.

With our unique location, 50 acres of land, away from crowded urban areas, our clinically proven treatment programme and duty of care to our patients, we are ideally suited to provide this service.

This dedicated unit was pioneered by our Major Incident COVID-19 Response Team, led by Dr Margaret McCann, CEO and Professor Jonathan Chick, Medical Director.

Secluded rehab clinic     

Screening and Admission

New admissions must answer a series of infection-control screening questions days in advance of admission to establish they are Covid-19 symptom-free. Referrers are required to ask the screening questions we provide as well as check the temperature of the potential patient and if possible conduct a swab test for Covid-19. 

On arrival, new patients go straight to Kirkurd House to start their admissions process and accompanying family members can drop them off at reception and return straight home. Patients receive two Coronavirus swab tests while at the new unit. We do not admit patients displaying symptoms of Covid-19.

After 7 days in this separate admissions unit our patients proceed to our intensive rehabilitation programme at the Castle Craig main clinic or in a house in Recovery Gardens.

Testing for Covid-19

We have protocols in place for swab testing any suspected case. So far any tests carried out at Royal Infirmary of Edinburgh laboratories have proved negative. We are a Covid-19-free hospital and aim to remain so through best practices of screening and hygiene measures.

Facilities at the Unit

The Kirkurd Unit contains 10 single, en-suite bedrooms, two sitting rooms and a medical centre. One sitting room doubles as a room for groups, lectures, pilates and Mindfulness meditation. Castle Craig’s 50 acres of grounds provide the ideal location for accompanied outside walks away from the rest of the hospital patients. Patients eat together in a shared dining room. 

We have an experienced medical and nursing team used to managing all types of detoxification from alcohol and drugs. Kirkurd Unit medical centre is staffed by 1-2 registered nurses and one healthcare assistant as well as our onsite 24/7 Medical Officer and a Senior Therapist. 

Much of the initial therapy at Kirkurd is provided on digital platforms so patients can join the rest of the community at Castle Craig.

Our Commitment to our Patients and Referral Partners

Castle Craig Hospital is committed to fulfilling a duty of care to our patients and providing a safe place for those people who continue to require admission for the urgent treatment of addiction during this time of heightened awareness of the transmission and effects of the Coronavirus. Patients are admitted to Castle Craig from the UK and overseas.

We have been working closely with Health Protection Scotland, NHS Borders and local public Health advisors and we are confident we have all necessary procedures in place. 

More Information

For more information on the Screening and Admissions Procedures please contact our Admissions Department

Visit for our latest Covid-19 Preparedness & Response Updates.

Statement issued: 20 March 2020

Addiction Recovery Support During the Coronavirus Epidemic

In the midst of the coronavirus epidemic, the biggest factor that will affect your day-to-day life is limiting public interaction. You may need to work from home, might avoid visiting elderly relatives, limit public gatherings and if you have children you will need to look at home-schooling them should the schools close. If you have symptoms or have been in contact with someone who has the virus you will need to self-isolate. As a person in addiction recovery, this makes things complicated. After all, you need to attend frequent recovery fellowship meetings, especially in the first months after treatment. 

While the coronavirus is something to be wary of, it does not have to affect your recovery. In addition to taking everyday precautions there are many things you can do to ease any anxiety you may be experiencing. 

Peer-support meetings such as Alcoholics Anonymous, Narcotics Anonymous and Cocaine Anonymous can make small changes to improve hygiene and help prevent spreading the infection. Or if you need to self-isolate at home, you can access online AA meetings and teletherapy, to keep up with your treatment or continuing care plan.

The official guidelines around who needs to self-isolate and what kind of public gatherings are still permitted are changing daily so read the latest government advice.

Preventing Coronavirus Spread at Addiction Support Meetings

Alcoholics Anonymous, Narcotics Anonymous, Gamblers Anonymous and Cocaine Anonymous and other fellowship meetings

If you continue to attend peer-support meetings such as AA, there are extra steps you can take to prevent infection and to help attendees feel more comfortable in the environment. In addition to following basic hygiene practices, here are some suggestions on how to act:

Don’t Hold Hands

When greeting others or during the Serenity Prayer, you’re probably used to holding other people’s hands. For the moment, it is best to avoid this. Instead, suggest interlocking elbows with the group or create a circle by holding on to another object, or tap shoes with each other, to avoid physical contact.

Whether you follow this method or not, it’s still smart to use hand sanitiser or wash your hands afterwards as a precaution. Suggest that everyone do this to prevent hurting someone’s feelings.


Instead of coughing into your hands, cough into the crook of your elbow so as to prevent spreading the virus to others.

Serve Food and Drinks Carefully

If you continue to serve food and drinks at the meetings, bring serving tools so that people do not physically touch any of the items. Ensure items have been prepared using gloves. Servers may want to wear gloves as an extra precaution. Wash your hands before eating. 

Keep in Contact

Make sure you have everyone’s phone numbers and emails to keep them updated on any scheduling changes or updates. People can also use this to let others know when they will not be attending a meeting. 

Come Up with a Plan B – Online AA Meetings

If you need to self-isolate or your peer-support group does not feel comfortable meeting in the future, come up with a plan to meet virtually or via a conference call. Some fellowships already implement this to improve access to those living in remote areas. You can also start your own group chat via text, WhatsApp, or Skype. 

Group fellowship meeting

Online Addiction Recovery Support Meetings During the Coronavirus Epidemic

A strong network of addiction recovery support and is crucial in treatment and recovery, so it is necessary to keep attending some sort of meeting, even if it is online. If your regular group doesn’t organise one there are plenty of other options available online.

Finding Online Resources for Addiction Support

Online Recovery Groups is endorsed by the therapy team at Castle Craig. is a free online platform offering over 130 live online recovery fellowship meetings per week, ranging from Alcoholics Anonymous to Cocaine Anonymous, Alanon to eating disorders anonymous to name but a few. Meetings are run by fellowship chairpersons who invite members to share among the group. Participants register for the site and can attend meetings anonymously or speak and be active. 

Patients at Castle Craig will be making use of during the Coronavirus outbreak, as an alternative to visiting Edinburgh and other local towns for meetings in the evenings.

Both Alcoholics Anonymous and Narcotics Anonymous, as well as other fellowships, have online meetings, which can be found on their websites. These are usually done via Skype.


Alcohol Change UK lists a number of resources for advice and virtual support. If you need help, you can contact free and confidential helplines such as Drinkline at 0300 123 1110 or the AA UK helpline at 0800 917 7650. In Wales, Dan 24/7 runs a round-the-clock support service at 0808 808 2234. 

Online Therapy

Another option is finding a private counsellor that offers video sessions. Online counselling has become very popular in the recent years and can help in such situations. Services such as BetterHelp can be useful when you are unable to reach out to others. If you are already in touch with a therapist, you can ask them to arrange an online or phone meeting with you as well.

Teletherapy at Castle Craig

Patients of Castle Craig can sign up for teletherapy as part of continuing care. Our teletherapy programme includes 10 private counselling sessions with one of our expert addiction therapists via webcam, and family sessions can be arranged as well.

Teletherapy is a useful tool in aftercare, even without the current coronavirus situation. Anyone can benefit from it as an accompaniment to their post-treatment plan. Its cost may also be covered by your medical insurance.

While it is not a substitute for peer-support meetings, it is an option if you are not able to find an alternative.

Teletherapy online therapy

For more information about our Teletherapy packages please call us on 0808 231 1504. 

Coping with Coronavirus Anxiety and Stress in Isolation

The coronavirus epidemic can worsen your anxiety, especially if you cannot go to meetings or are worried about becoming sick. Should you be in self-isolation, this can also worsen feelings of loneliness and make it more difficult to deal with relapse triggers.

Overcome Boredom

Having hobbies is important in recovery but if you’re in self-isolation, you may be limited to what you can do. Try to find something interesting to occupy you time that you can do alone and/or indoors. Worst case scenario, this may be a good time to catch up your reading or watch a few films you’ve missed.

Journal writing or v-logging is always a good idea and doubles as therapy. If you feel comfortable with social media, you can even post it online and maybe connect with others in similar situations.

Avoid Loneliness

Being alone, especially in such a stressful time, can raise the risk of relapse. Social support is important even if you’re not in self-isolation, but even more so if you are limited to human contact.

Make sure to stay in touch with your friends or family as much as possible, even if it’s just to exchange a few messages. This is another reason why online support groups are more important than ever. You can also join online forums or chat rooms.

If you ever feel uncomfortable after spending time alone, try having some music in the background or keep the TV on. However, if the coronavirus is causing you distress, avoid watching the news as it can be triggering.

Create Comfort

Since you’re spending a lot of time in one space, you should make it as comfortable as possible. Cleaning up and organising should be your first step. Having a neat environment is better for concentration and mental well-being. In addition, try to decorate if possible. At least, add a few relaxing details such as candles.


Self-care is just as important now as ever. Make sure you continue to eat well and exercise. There are plenty of things you can do indoors, such as yoga or Zumba. You can find plenty of fitness videos on YouTube that don’t involve any extra equipment.

Meditation and relaxation techniques should be practiced daily, especially if you have anxiety. You’ve probably already learned a few methods in addiction treatment, but you can also find resources and videos online. There are plenty of apps, such as Calm, available as well if you have a smartphone or tablet.

Meditate and yoga

Don’t watch infection rates – watch recovery rates!

If you find yourself compulsively watching rates of deaths and infection, instead try to focus on the more positive recovery rates figures found on the John Hopkins CSSE. Thousands of people are recovering from the coronavirus around the world every day. The recovery rate may be even higher than this as many people who have very mild symptoms are not being tested and confirmed as cases.

Keep Calm and Carry On

With or without the coronavirus, there will always be circumstances that make your recovery journey more difficult. In these moments, you have to remind yourself how far you’ve come and that you can keep going.

As of right now, there is no need to stop attending meetings or socialising with friends, as long as you take the necessary preventative measures. However, if you are highly anxious about the situation, take the necessary steps to make yourself feel better. If this means self-isolating, this does not have to mean you’ll be alone.

Whatever you do, maintain contact with your friends and family, and continue attending meetings, even if virtually. Ask your support group or therapist about what you can do to ease anxiety. Patients of Castle Craig can always call our helpline at 0808 231 1504 for advice and support.

What Is the Coronavirus?

COVID-19, also called the coronavirus, is a flu-like illness that affects your lungs and respiratory system. It is just one type of coronavirus, a category which actually describes a large group of viruses. This category includes the common cold, as well as SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome).

It has similar symptoms to the flu, which include:

  • Fever
  • Cough 
  • Breathing difficulties
  • Muscle aches and pain

Like the cold and the flu, coronavirus doesn’t have a directly curative treatment. If sick, you may be given medication to ease symptoms while you rest and wait for your immune system to fight the virus.

Complications can arise if the virus spreads to your lungs, in which case additional medical treatment, such as oxygen provision, may be necessary. However, this is relatively rare, mostly affecting the elderly and those with underlying medical conditions, and still possible to recover from.

Should I Be Worried About the Coronavirus?

Coronavirus Anxiety

The coronavirus, or COVID-19, is dominating the news right now, and is increasingly becoming an issue in the UK. As a result, it’s causing a lot of worry and anxiety for many people. However, it is not something to panic over.

Although it’s widely talked about in the media, it is important to take statistics rationally. Globally, there have been almost 120,000 cases, more than half of which have already recovered.

Primarily, the virus seems to be more dangerous for the older population (60+) and people with underlying medical conditions, especially respiratory problems or lowered immune systems.

Unless you fall into that category, it is at present safe to continue going to work, support meetings, and public places (although online work and meetings are safer). At the same time, it is necessary to be extra cautious with hygiene practices, to prevent the further spread of the virus. 

How to Prevent the Coronavirus at AA and NA Meetings

Even if you do not fall into the high-risk category, it is important to remember that others may do so. The coronavirus spreads easily and a person can infect others even if they do not show any symptoms. Hence, always take the necessary steps to prevent others from becoming sick.

As peer-support meetings involve people gathering in groups in a closed space, make sure everyone who attends knows what to do and what not to do.

Practice Proper Hygiene

The virus is believed to be spread by contact with respiratory droplets (e.g. from sneezing or coughing). Therefore, the best thing to do is to practice basic hygiene techniques, such as:

  • Washing hands often and after being in any public location. Do this for 20+ seconds with soap and water or use a hand sanitiser.
  • Avoid touching your face, especially if hands are not clean
  • Avoid contact with people who show any sickness symptoms
  • If you sneeze or cough, do so into your elbow, not your hand
  • If you are sick, stay at home and self-isolate if possible

Washing hands may seem simple, but it is truly the best way of preventing illness. To do so correctly, use soap and water (it doesn’t have to be antibacterial as plain soap is naturally effective at killing germs). Scrub your hands for at least 20 seconds. If soap is unavailable, a 60%+ alcohol-based hand sanitiser also works well.

Also remember that after your face, the thing your hands touch most often is probably your phone, so give that a good regular clean too.

What Doesn’t Help

Face masks are relatively ineffective if you want to avoid getting sick. However, it is recommended for people who have any symptoms, even those of a simple cold, to wear one while in public. Of course, if you are sick, it is always best to stay home. Feel free to wear a mask at any time if it makes you more comfortable, but understand that this may cause others to be wary. 

Antibiotics are also ineffective, as they don’t work on viruses. They will not work to prevent or treat the disease. Do not take antibiotics unless you were prescribed them for a different condition.

The Latest Information

Most importantly, if you suspect you are seriously sick, do not go to the A&E or the doctor. Instead, call the NHS on 111 for advice and instructions.

The advice keeps changing so for the most up-to-date advice on the coronavirus situation visit the NHS coronavirus page or read the latest government advice.

Borderline Personality Disorder (BPD) and Alcohol

Borderline personality disorder (BPD) is a highly complex, stigmatised, and often misunderstood mental illness. So is addiction. Either one can make life very difficult for a person. Having both makes for an even bigger problem. Sadly, the rate of comorbidity between BPD and addiction, especially to alcohol, is extremely high. About half of those diagnosed with BPD meet the criteria for substance abuse or alcohol abuse disorder. This is one of the highest rates of comorbidity with alcoholism among all psychological illnesses.

When a person has both illnesses, diagnosis can be very difficult, mainly because both BPD and alcoholism share many common symptoms. This is known as a dual diagnosis. Both illnesses can be dangerous if left untreated, and treatment for either one is not an easy task. Treatment when both are involved can quickly become even more complicated, but that is also when it becomes most necessary.

What Is Borderline Personality Disorder?

Borderline personality disorder, also known as emotionally unstable personality disorder (EUPD) is a mental illness characterised by fear of abandonment, rapidly changing moods, impulsive behaviour, and poor sense of self-identity. The term “borderline” refers to the fact that the symptoms border on both psychotic and neurotic behaviour.

It is estimated that between 1-2% of people in the UK have BPD, but because it is so difficult to diagnose, the numbers could be much higher. BPD falls on a spectrum from mild to severe, depending on what symptoms (and to what extreme) the person has. People with BPD often experience:

  • Intense emotions
  • “Black and white” thinking
  • Going to extreme efforts to avoid abandonment
  • Idealisation, attempts, or acts of self-harm and/or suicide
  • Weak temper and poor anger-management
  • Stress-related paranoia or dissociation
  • Sensitivity to criticism or rejection
  • Chronic feelings of emptiness or depression
  • Unstable relationships

The intense emotions they feel are not only their own. If they see someone in pain, they will feel the pain themselves as if it is their own. While this makes it easier for a borderline to connect with others, it also makes them too quick to get attached.

Unfortunately, people with BPD are often seen as childish, manipulative, and attention-seeking because of the way they act. Their rapidly changing moods and switches between love and hate (or “splitting”) can make it seem as if they have different personalities.

For this reason, many people find it difficult to live or deal with someone who has BPD, which makes building relationships hard. Ironically, this only contributes to the fear of abandonment and makes things worse.

These symptoms can appear in early childhood and quickly become overwhelming. Because of this, about 10% of those with BPD end up committing suicide, men more than women.

What Is BPD Like?

Read the words of Scarlett to find out what BPD is like:

“Being borderline is very much like living in black and white. You’re either ecstatically happy or convinced that it’s the end of the world. There is no in-between. Every emotion is constantly on full volume. It very quickly gets to be too much and people always look at me like I’m crazy, even when I’m happy. 

The same goes for my thinking. Like with my boyfriend. If all’s going well, I’m head-over-heels in love and planning to spend the rest of my life with him. And if he comes home and is in a somber mood, I’m convinced he’s mad at me and going to break up. I realise what I’m thinking and why and that it sounds stupid, but there is no logical explanation in the world that will get me to calm down. Therapy doesn’t help.

“Most of the time, I don’t feel happy with life and I get frustrated very easily”

So I often push people away as a precaution or keep my distance from the start, which means my social life is nonexistent. And it’s hard to make friends because I have little interests unless I’m obsessed with something, which is always short-lived. I’m literally always bored. I’ve been told this is because I have no self-identity. I don’t know who I am, so I don’t know what I enjoy.

Most of the time, I don’t feel happy with life and I get frustrated really easily. I hate when I’m depressed and people say, ‘Go and hang out with your friends or do something you enjoy!’ And I’m thinking, what friends and what do I enjoy? I’ve never been able to explain to anyone how I feel, which is so frustrating. If anything, people say I just want attention. I guess that’s partly true but it’s much more than that. I want someone to care. That’s something I’ve never had and don’t think I ever will.” – Scarlett

Does any of this sound familiar? Many people who abuse alcohol can probably relate to this description of BPD, and the issues it causes.

Alcohol and BPD

Due to extreme emotional changes, constant fear, anxiety, and depression, it is also not unusual for someone with BPD to engage in self-harming behaviour. In addition to acts such as cutting, this includes drugs and alcohol, which are both used as ways to escape or bury intense feelings.

Because borderlines are highly impulsive, alcohol or drug abuse is very dangerous for them. It can quickly lead to addiction. In fact, some professionals even say that a person with BPD has an “addictive personality”.

Why Is Alcohol Abuse So Common in BPD?

Alcohol is the most common form of self-medication for borderline people, because it seems like a cure-all. Some think it helps ease the intense emotions or pain, some see it as a social aid, and others find it as a source of entertainment, especially when they’re alone.

People with BPD have also been shown to have more cravings for alcohol than people without BPD. This may be because alcohol stimulates the endogenous opioid system (EOS), which is often under-stimulated in those with BPD. Cocaine and opioids act similarly on EOS, and coincidentally, are also the other two most-commonly abused drugs among borderlines.

Experiences of BPD and Alcohol

Lara, Lucas, and Vanessa, all diagnosed with BPD, share why they use alcohol and other substances to self-medicate:

“For me alcohol balances out the worst of my symptoms of BPD, it helps me relax, not overshare, and usually balances out my rage. I think I enjoy the happy buzz a bit too much.

With a family history of alcoholics I have always been more careful with alcohol than is probably necessary. I have also been alcohol-free since last October simply because I do not want to develop a problem.

In addition to this however I also have a problem with overeating, and I am currently attending Overeaters Anonymous, which works through the same book and materials as Alcoholics Anonymous.”  – Lara

“I don’t know if I’m an alcoholic, but I definitely over-drank when I was younger. These days, I’m on antidepressants, and I self-medicate with weed and alcohol. I use the alcohol to enhance the effects of the weed. I prefer something with a high proof. Sometimes I’ll have the antidepressants along with it. And hopefully, I will have achieved a state of mind where I am blissfully ignorant of all my problems!” – Lucas

“I feel like I have to drink to be normal and fit in. It helps me open up and blend in with the rest of society and slows my overthinking. Keeps me from internalising things. But it also backfires. 

Drinking too much at home has led to severe acts of self-harm for attention and put me in the hospital. Things I would like to think wouldn’t have happened if I wasn’t so screwed up. I drink nearly every night and binge drink all day and night on the weekends. It doesn’t interfere with my work life, thank God, but it’s still a lot of alcohol.” – Vanessa

BPD and Alcoholism Share Many Similarities

If you compare the symptoms of BPD with signs of addiction for alcoholism, you will spot a lot of similarities. This is why it can be difficult to diagnose whether a person has one or both illnesses. Some of the many aspects BPD and alcoholism share are:

Unhealthy Coping

Alcoholics tend to use alcohol as a coping mechanism. Be it stress, day-to-day problems, or other emotions. So do people with BPD. Borderlines are also likely to use alcohol regularly and in excessive amounts, often a warning sign of alcoholism.

Unstable Behaviour

Alcohol, especially with chronic or long-term use, alters brain function, so it can cause mood swings and angry outbursts, often seen with BPD. Alcohol can also affect memory and concentration, both of which are common for borderlines in times of stress or dissociation.

Borderlines are already impulsive and have a high risk of self-harming behaviour. Alcohol makes people lose their inhibitions just the same, and increases the risk of suicide. Combined, the two make things worse. Alcohol abuse can easily push a person over the edge, especially if they’re already close to it.

While alcohol often feels like a cure for symptoms of depression and anxiety, it actually worsens both over time. In regards to BPD, it can exaggerate all symptoms, which are probably not mild to begin with.

Dysfunctional Lifestyle

Alcoholism can lead to neglect in self-care, relationships, work, and finances. Something that many people with BPD have to deal with even if they’re sober. A person with alcoholism may be missing out on responsibilities due to drinking or a hangover, while a person with BPD may do so because they believe socialising leads to them being hurt.

To cover up these faults, alcoholics may lie about their use or act in a manipulative way. This is something borderline people are often accused of, and may do subconsciously as a means of preventing abandonment.

Codependent Relationships

Borderlines can get easily attached to a person and have a hard time letting go of a relationship, even if it gets violent. It is also not uncommon for someone with BPD to end up with someone with harmful narcissistic traits. Those people tend to exhibit the exact characteristics the borderline yearns for. They appear caring, but they end up controlling or abusive. But due to fear of abandonment, it is not easy to leave, even if things get bad.

Likewise, alcoholics, especially women, tend to end up in codependent relationships, especially if their partner is an alcoholic too.

Learn how to spot a codependent relationship, and what steps you can take to get out of one.

A Traumatic Past

The causes behind BPD are unclear, but are believed to be a mix of genetic predisposition and how the person was raised, with childhood trauma playing a significant part.

With alcoholism, there is also usually some sort of underlying issue, not necessarily a disorder, but some reason for why a person turns to alcohol.

The Difficulty in Diagnosis of BPD and alcoholism

BPD is very difficult to diagnose. It can take years to be identified as a borderline, because the disease is so complicated and even medical professionals often have poor understanding of it. Professionals also believe there is a lot of under-diagnosis, over-diagnosis, and misdiagnosis when it comes to BPD.

It is even more difficult when substance abuse is involved. For example, it is possible for someone to be mistaken for a borderline when they simply have alcohol use disorder or vice versa. It is also not uncommon for a person to get under-diagnosed with only one illness, when in reality, they have a bigger problem.

It’s not just substance addiction. BPD is sometimes confused with post-traumatic stress disorder (PTSD), and medical professionals often see BPD as a combination of many  psychiatric illnesses, because nearly all symptoms tend to overlap with something else.

How Do I Know if It’s BPD or Alcohol Abuse?

It is not advised to self-diagnose when it comes to BPD, but if you have exhibited a majority of BPD symptoms over many years, you should consult a professional. Even so, you shouldn’t expect a “yes” or “no” immediately. BPD takes time to identify.

If the symptoms have only shown up or become more prominent after you have started using alcohol (even in moderation), it may be not BPD at all. Taking a break from alcohol to test a theory wouldn’t necessarily provide any insight either.  Although if you have trouble quitting drinking, you may have alcoholism.

People with BPD who have become sober often report an alleviation of their symptoms. However, the borderline side doesn’t disappear completely.

Treatment for Borderline Personality Disorder

Treatment for BPD is a complex topic. First, those with BPD require special care, which may not always be available. Patients seeking treatment report having difficulty finding the right professional, as not all are knowledgeable about BPD and many don’t want to deal with BPD patients altogether.

People with BPD can also be difficult to work with. They are hard to convince that they need help and are reluctant to seek it themselves. They are also more likely to drop out of treatment, especially if things get unpleasant.

The standard course of treatment for BPD is therapy, either CBT (cognitive behavioural therapy) or more preferably DBT (dialectical behavioural therapy). DBT is essentially CBT designed for BPD patients, and has been proven to be more helpful in reducing self-harming behaviours.

There is no medication available for BPD, although sometimes it is prescribed to alleviate, but not treat, certain symptoms.

If symptoms get too severe, it is possible to be hospitalised, either voluntary or not. Inpatient treatment is recommended for those at a high risk of suicide or harm to someone else.

Hospitalisation may sound severe but it isn’t unusual for a person with BPD to request voluntary admission. They may also go for other reasons too, such as addiction. When more than one condition is involved, inpatient treatment is often found to be helpful because it is more intense.

Taylor’s Experience of BPD and Alcohol

“I found out I had BPD when I was a teen. The year after, I had my first drink and I realised how calm and relaxed I felt. I was finally able to socialise without the constant second-guessing and rapid emotional cycling! 

I drank a lot to replicate that feeling until I turned 18. Then, I was drinking any time anything felt “bad”, and with BPD, that was very frequently. I moved in with my alcoholic boyfriend and we ended up wrecking our lives. Lost everything. Our relationship turned abusive. 

So I left and went to an inpatient rehab center for 45 days. I haven’t had a drink since. They helped me work through a lot of trauma, gave me a sense of community, and helped me find long-term professionals to help with my BPD. That was five years ago and I haven’t gone back to drinking.” – Taylor

Treatment for BPD can take years or decades, and for some people it will remain a life-long illness requiring life-long attention. However, therapy does help alleviate many symptoms, and is recommended, no matter the severity.

Treatment Options for BPD and Alcohol Abuse

Alcoholism, depending on the degree, may be dealt with via self-regulated treatment, or it might need medically supervised inpatient care. A typical inpatient alcoholism programme includes a period of detox, psychotherapy, and aftercare. When it comes to dual-diagnosis however, attendance at an inpatient rehab is highly recommended.

Because alcoholism and BPD combined exaggerate one another besides being potentially lethal on their own, finding proper treatment is crucial. In addition, people with any type of dual-diagnosis are more prone to relapse.

Why Residential Rehab is Better

When it comes to addiction and any comorbid psychological disorder, it is always advised to treat both at the same time. This can be done much more efficiently at a residential rehab centre. Many outpatient facilities are unable to provide the intensity of care than an inpatient facility can.

At Castle Craig Hospital, all aspects of a patient’s diagnosis will be addressed and relapse prevention will be an important part of the programme.

No two persons with a dual-diagnosis should be treated the same. This is because every person has their own unique situation. Every patient at Castle Craig is carefully evaluated and given a personalised treatment plan to make sure that all their well-being needs are met.

One of the main benefits of inpatient facilities is that they allow a person to escape their normal environment, which can be helpful if that environment is toxic or triggering in any way. Inpatient facilities and group therapy also provide a sense of belonging, which someone struggling socially will appreciate.

Call us now on +44 1721 788 193

In regards to therapy, Castle Craig offers both CBT and DBT. We have both group and individual therapies, along with a number of complementary therapies. We also have specialised groups, such as for women, or those with traumatic experiences.

Castle Craig also strongly focuses on continuing care, which is necessary for someone with both alcoholism and BPD, both of which are considered life-long illnesses. We also offer extended care programmes, which can be important for certain patients.

Whether you’re struggling with alcohol abuse or another addiction, it is important to get help as soon as you realise you have a problem. If you suspect that you have an underlying psychological issue, such as BPD, it is even more critical to do so.

Castle Craig has helped over 10,000 people with all types of addictions and accompanying psychological problems. No matter what troubles you’re facing, we are glad to provide advice and support. If you are concerned about your drinking or substance use, or would like to consult with us about treatment options, you can give us a call at +44 1721 788 193 or email us at

A Drug Summit Drums Up Support for Scotland

Drug summits are being held today and tomorrow to address the drug death epidemic in the UK. Ironically, this is happening in Glasgow, which is at the heart of the problem. 

For Scotland, this is literally a life-or-death turning point as the country has seen some of the highest numbers of drug and alcohol-related mortalities in the world while having a drastic decline in addiction treatment funding.

Since last year, Scotland has seen a 27% rise in drug-related deaths, with the majority of it being from opioid overdoses. Meanwhile, admissions to treatment centres, especially residential rehabs, have dropped. Today, it seems, access to rehab in Scotland is only reserved for the rich.


The Scottish Government is Shying Away from Serious Problems

Funding for rehab referrals via the NHS has fallen dramatically over the past two decades, and only appears to be getting worse. The current government strategy, of Scotland in particular, seems to be favouring community-based resources such as less-intensive programmes or substitution therapies.

The country has supported many harm-reduction programmes, and are even piloting a managed alcohol programme (MAP) in Glasgow while refusing to help people who genuinely want to be sober once and for all. It seems that the current Scottish government has a poor understanding of what addiction is all about. While these strategies may work for some, they do not help those with serious problems.


The Decline in Treatment Funding Spells Doom for Victims of Drug Addiction

Castle Craig is one of many rehabilitation centres that have noticed a major drop in NHS-funded admissions for addiction treatment. For example, Castle Craig has reported that in 2002, 257 people from Scotland were referred, but in 2019, only 5 were seen. 

Given the rise of the drug problem in the country, this is rather surprising. Especially since there are many people who are seeking treatment but simply cannot get access. Half of the patients in residential rehabs reported serious difficulty in getting proper help via the NHS. And those that make it through the initial stages often have to wait up to 12 months to actually receive said treatment.

Upon seeing these reports, Annie Wells, the Deputy Leader of the Scottish Conservative party, tweeted, “And we wonder why more people are dying now? This is why.” [@AnnieWellsMSP]

Annie Wells MSP

According to a recent article in The Herald, similar statements were issued by other residential rehabilitation centres in Scotland. So, it is not surprising that many UK treatment facilities, and not just in Scotland, have closed down over the years.

Castle Craig, for the moment, has been helping people with drug and alcohol addictions here on referrals from the EU as well as privately funded patients. However, being a Scottish-based rehab, it is disappointing not to be able to help out local citizens. While some criticise accepting foreign patients, Castle Craig says that there are always beds available for Scottish and UK-based residents.


Why Residential Rehab Is Important 

While there is a time and place for harm-reduction, it should not be prioritised over scientifically proven treatment strategies like residential rehabilitation programmes. Not to mention, substitution therapies, such as methadone treatment, are often mismanaged and may force a person into a worse-off situation than they were in before.

Many people who have an addiction also have an accompanying psychological disorder, such as depression, PTSD, or another mental illness. To properly treat the addiction, you need to treat the underlying issues as well. And this is very hard to do without an intensive approach like residential treatment.

Residential rehab is an absolute necessity for those suffering from serious alcohol or drug addiction. Many people who have hit rock-bottom claim that basic community-based resources and peer support groups are just not enough. 


William’s Story

For example, Wiliam Allan, who was once treated at Castle Craig for alcoholism, said, “I had been through community addiction teams, I’d been sectioned umpteen times, I’d had outpatient treatment, I’d tried Alcoholics Anonymous. Nothing worked…. if I hadn’t got into Castle Craig I wouldn’t be here today. That’s a fact.

Despite losing everything due to his addiction, residential rehab helped turn his life around. Currently, he is a major advocate for addiction treatment around the world and also works as a therapist at Castle Craig.


It’s Necessary to Make Smart Decisions – Now

Residential rehabilitation is a major key in the fight against the addiction epidemic and it cannot be removed from the frontlines. And many people who have been through addiction, understand this like no one else.

There have been many campaigns to improve the alcohol and drug addiction treatment strategy,  especially prior to the Drug Summit. One of many UK recovery-focused charities, FAVOR (Faces and Voices of Recovery), is calling for the government to declare the current situation as a public health emergency and increase funding for treatment.  

This doesn’t mean that rehabs will be a free-for-all. Residential treatment isn’t for everyone. A person needs to genuinely want to get better – they need to be psychologically ready for real change. 

So, the fact that the NHS does vet patients for the appropriate treatment route isn’t wrong. People should not be blindly referred via step-by-step procedural guides, especially if it won’t help them. However, people should never be turned away when they need support the most.

Since there isn’t a lack of beds in Scotland, and there’s apparently plenty of funding for alternative drug programmes, why are we facing a crisis? It seems that the problem is that the NHS seems to refuse treatment to too many of those that truly need it. And since, at the moment, there are far too many Scottish citizens on the waiting list, there needs to be a serious reassessment about priorities as soon as possible.

Update: Fri 28th Feb 2020

The results from the summit have been published.
There was an announcement from Joe Fitzpatrick at the conference yesterday promising £20million with 7.5 million specifically allocated to mental health and residential rehabilitation beds. That is a step in the right direction (and a bit of success in our eyes).

Fentanyl: UK’s Next Drug Epidemic?

When it comes to illicit drug use, heroin and crack cocaine are often considered the worst drugs someone can take. They are responsible for the majority of drug-related deaths and are the leading cause of concern in most countries. Now with synthetic opioids, particularly fentanyl, becoming more widespread, it seems that there’s a new epidemic coming. And soon, it is expected to hit the UK as well.

Fentanyl has been around since 1959, but it first made headlines in 2016, when it killed Prince, an iconic American musician. He died from an accidental overdose on the drug. 

Prince was prescribed the drug by a doctor, although the legitimacy of the prescription is under question. However, since then, fentanyl has become more common on the illicit drug market. It’s a major problem in the US and is now spreading globally. It is being sold as itself, under the guise of heroin, or laced into other drugs.

In the last few years, fentanyl-related deaths have increased dramatically. In the US, the rate seems to double each year. Other countries have noticed alarming statistics as well and in 2017, England and Wales reported a rise of 30% in deaths due to fentanyl. 

Since then, the death toll only continues to grow. With the drug rapidly seeping into the illicit drug market, it looks like the UK may have a serious problem ahead.

What Is Fentanyl?

Fentanyl is a highly addictive synthetic opioid that is 50-100 times stronger than morphine. Its effects are similar to heroin but much stronger. However, it’s an extremely easy drug to overdose on. As little as 2mg of fentanyl is enough to kill a person. 

Fentanyl is occasionally prescribed to people in severe pain due to cancer, surgery, or injury, often because they are immune to other opioids. It is also sometimes used during anaesthesia. 

Today, fentanyl is largely illicitly manufactured and heavily present on the street drug market. It can be found in many forms, from pills to liquid to white, green, or brown powder. It has also been sold as skin patches, nasal spray, blotter paper, and candy. It is nearly impossible, without proper test equipment, to tell if a drug has been adulterated with fentanyl.

Since it’s cheaper to make, fentanyl is often mixed in with heroin or other opioid drugs to increase their strength while lowering the cost. It is sometimes used to make counterfeit heroin or painkiller pills. It can also be used as an adulterant to amplify the effects of unrelated drugs such as cocaine.

Risks of Fentanyl Use

Fentanyl is essentially a more potent form of morphine and heroin, so its side effects are similar. They include:

  • Drowsiness
  • Nausea/vomiting
  • Confusion
  • Constipation
  • Respiratory depression
  • Loss of consciousness or coma
  • Dangerously low heart rate

Another problem is that the majority of people are not aware they are taking fentanyl, which is the main reason the drug is so dangerous. If people don’t know what they’re taking or how much, they can easily overdose, even from one episode of recreational use.

In addition to these, the biggest risks of all seem to be developing an addiction. Recent data from the US shows how dangerously addictive the drug can be. 

The Rise in Fentanyl Addiction

Fentanyl is well-known in the US, and there is a strong demand for the drug among regular consumers. Heroin, prescription painkillers, and other opioid drugs have been a leading cause of chaos in the United States. The US is known for having the highest number of opioid-related deaths of any country in the world. 

In a recent study by John Hopkins Bloomberg School of Public Health, it was shown that there is a staggering amount of opioid users that prefer fentanyl over heroin or other opioids. That preference seems to be higher among younger adults – those under 40 years of age – and those of caucasian race. 

Drug users with a fentanyl preference are also more likely to indulge in daily drug use – 92% admit to doing so. They also have more overdoses (and more frequently) than those who do not prefer fentanyl. Despite said overdoses, the participants did not show any fear of the drug, proving the potential addictiveness of the substance.

If fentanyl spreads to UK streets, it can quickly rise to epidemic levels. When it was first introduced to the market in the US, it caused a lot of damage in a very short period of time. From 2013 to 2016, there was a six-fold increase in deaths from synthetic opioids. And to this day, that rate continues to climb.

Is Fentanyl Going to be a Problem to the UK

Although fentanyl hasn’t been as widespread on British drug markets before, it is becoming an issue now. This is evident from rising numbers in fentanyl-related deaths since 2016.  

The news is worrying, considering that opioid addiction is a serious problem in many parts of the UK. Given the evidence of fentanyl’s addiction potential, should this drug hit the black market in high numbers, it can cause a lot of damage in a very short period.

The issue has already been spotted in various parts of the UK, and more so in North East England. Much of the rise in opioid-related deaths in that area is suspected to be because of fentanyl. Because fentanyl isn’t normally screened for post-mortem examinations, those numbers could be even higher.

In addition, it was noted that a significant number of people in treatment for opioid addiction tested positive for fentanyl. The majority, about 80% of the patients, was not aware they had been exposed to it.

What makes things worse is that the year 2017 was also the first time that carfentanyl was listed in the UK’s drug-related death statistics. Carfentanyl is an even more potent synthetic opioid about 10,000 times stronger than morphine. It is normally used as an elephant tranquilliser. 

Addressing the Incoming Epidemic

There are already a number of measures taken in the UK to reduce opioid-related deaths. For example, users can utilise needle-exchange services, acquire Naloxone (an emergency medication for overdoses), or sign up for opioid substitution therapy (e.g. methadone).

However, these may not help very well when it comes to dealing with fentanyl. Naloxone is unfortunately less reliable when it comes to synthetic opioids. Given that overdoses are the number one issue with fentanyl, this is worrying. And noting how addictive fentanyl is, as shown in the US study, users are unlikely to voluntarily switch to a weaker drug such as methadone.

Instead, it is best to prevent the problem in the first place. Aside from protecting the UK from fentanyl, it is necessary to address substance abuse in people who are most likely to be exposed to fentanyl. This is especially important for anyone currently abusing opioid drugs.

Detox for Fentanyl and Opioid Addiction at Castle Craig

Having treated patients from all walks of life for over 30 years, Castle Craig can help you or someone you love. We offer treatments for all sorts of addictions, including those for fentanyl and other opioid drugs.

Knowing how serious a fentanyl or opioid addiction can be, we aim to provide the best possible care. Psychiatrist-led detox is crucial when dealing with drug addiction, and in some cases, as with opioids, it can be dangerous if done wrong. Detoxification from opioids can be very unpleasant and even life-threatening.

At Castle Craig, our opioid detox programme includes 24/7 medical supervision, which is needed when dealing with such a serious drug. If necessary, we help our patients slowly taper their use with substitution therapy.

Fentanyl Rehab Therapy

Of course, treating opioid addiction goes beyond detoxification. It is necessary to address the problem via therapy as well. Castle Craig offers a variety of therapeutic techniques, majorly based on CBT, DBT, and the 12-steps. Aftercare is also part of our treatment plan, to assure a long-lasting recovery.

Don’t hesitate to contact us about our addiction treatment programmes. We can offer helpful advice for you if you’re dealing with opioid addiction or if you’re worried about someone else’s substance abuse. Our offices can be reached at 0808 252 5615 or via email at

Managed Alcohol Programmes: A New Strategy for Harm Reduction

Is one solution to alcohol abuse… more alcohol? Some in Canada think so. A few years ago, several cities have implemented managed alcohol programmes (MAP) to tackle severe alcoholism, particularly among those with an unstable housing situation and who drink non-beverage alcohol.

After several years of seemingly successful results, other countries including Australia and Scotland are interested in replicating the concept. Already, a homeless shelter in Glasgow wishes to pilot the idea. 

While it’s true that such a programme appears to be beneficial in some way for some people, there is a lack of good evidence that these programmes are effective in their aims, which are to improve health and reduce harms that people accrue for their drinking.

What Are Managed Alcohol Programmes?

A managed alcohol programme could be described as a means of addressing alcoholism via harm reduction. It can be compared to methadone substitution therapy and prescription heroin programmes, both of which are also implemented in Canada. The idea is the same, but aiming to deal with the growing problem of non-beverage alcohol consumption among other issues.

Participants are provided with regular doses of alcohol throughout the day. In addition to an alcoholic drink, participants are provided with housing, food, and various forms of social support, usually partially paid from their social security benefits.

As an example, a centre will offer measured servings of alcohol (mainly wine or beer) at regular intervals from morning until bedtime. This may be every hour or so, provided the person doesn’t appear intoxicated. Ultimately, the drink-dispensing schedule is decided by the on-site staff and the person in care. And in order to keep things in check, anyone who consumes alcohol outside the facility is temporarily banned from the “bar”. This rule, however, may vary between MAP locations.

What’s a Non-Beverage Alcohol?

A non-beverage alcohol (NBA) is any consumer product based on alcohol that is not intended for internal consumption. Some examples include:

  • Mouthwash
  • Hair spray
  • Hand sanitiser
  • Rubbing alcohol
  • Perfume or Cologne
  • Antifreeze

Consuming such substances can be very damaging to health partly due to other additives as well as the alcohol content. In many of these examples, the alcohol itself is also a problem. Beverage alcohols are made with ethanol, which is not “healthy” although not toxic either. However, some non-beverage alcohols may contain methanol or butanol, which can be lethal.

Someone suffering from severe withdrawals who cannot get access to drinkable liquors can easily, out of desperation, turn to an alternative, despite the potential consequences.


Man misusing alcohol by the side of the road -

Why Managed Alcohol Programmes Are Getting Attention

MAPs are peaking people’s interests because, at least in Canada, they would appear to be addressing all the main issues. For example, it may not make sense to give alcohol to an alcoholic. However, when alcohol dependency is serious, stopping suddenly can be life-threatening without proper care. And if a person cannot get the right support, such as residential detox, the argument is that this is the second-best option.

In addition, MAPs are focused on people who are homeless or do not have a stable living situation. This is also a major issue in Canada, among other reasons, due to a high level of displaced indigenous populations. 

Among the general population, alcohol abuse is estimated to affect only about 4% of people globally. For the homeless, this figure rises to about 38%. For both groups, alcohol problems mean they cannot partake in most social housing schemes as such programmes almost always require you to be sober. 

Also, as mentioned before, MAPs aim to address a different issue – the consumption of non-beverage alcohol. In countries such as Canada, where alcohol is expensive and thus not easily available, people with a serious dependency often turn to alternatives to get their fix. 

Because of this, many of those who need help simply have nowhere to start. Which explains the argument that, in a sense, MAPs are offering an alternative approach to resolving an ongoing problem.

Have Managed Alcohol Programmes Been Beneficial?

Several studies claim that MAPs do more good than harm. Mainly, this is seen on a social level. For example, people who consume NBAs and/or go on binge-drinking sessions and suffer subsequent withdrawals often end up in hospitals or in conflict with law enforcement. Or in extremely cold weather, homeless people may end up dying due to exposure.

This takes a toll on the community and adds extra stress and expenses for public services. After MAPs were implemented, it seemed that the number and consequences of such episodes dropped.

Many participants also claim that MAPs have helped them gain some control over their lives. While they, for the moment, remained dependent on alcohol, they didn’t have to worry about being homeless or where to get their next drink. In a way, one could say they became functional alcoholics. 

Others took it a step further. As they “got their heads together”, they began to cut down on their drinking. Some were finally able to go on to rehab after spending time in a MAP – something they couldn’t do before.

Why Managed Alcohol Programmes Are Controversial

Given that MAPs have not been around for long, there is not enough evidence that they work. Upon closer examination, for every positive point, there is a potential argument against it. Even if there are seemingly obvious benefits to them, it is important to examine such programmes from both ends, as things may not be as clear-cut as they seem.

The Reduction in Harmful Drinking

While many participants managed to learn to regulate their drinking and abstain from NBAs, some also started consuming more alcohol overall. Prior to the programme, most went on binge-drinking sessions when they could acquire alcohol and endured sobriety when they couldn’t. With the programme, they had daily access to alcohol. And so, some participants increased their total consumption.

In one study, long-term (2+ months) participants drank about 7 standard drinks fewer per day, but consumed alcohol on average about 5.5 more days per month. However, the study also noticed that newer participants (<2 months) were more likely to consume NBAs off-premises.

In the long run, this wouldn’t be helpful is, as some reports find that daily drinking does more harm to the body, especially the liver, than binge episodes. It seems that while MAPs solve one problem, they create another. So far, there has been no proof that these programmes do anything for a person’s physical health.

It’s an Ethical Issue

All managed alcohol programmes are experimental – that is, experimenting on a vulnerable public. Although all participants are voluntary participants, one can argue that they may not be in the right state of mind to decide what is best. 

In essence, managed alcohol programmes are the opposite of the abstinence-based approach, which sticks to the “no means no” principle on alcohol intake. However, someone who is dependent on alcohol will not be likely to say no if offered a free and ongoing supply, especially if the alternative is to give it all up for good. 

Lack of an Alternative

Thus, the argument above raises the question: if a full rehab programme were also offered alongside, would any of the MAP participants volunteer for that instead? And if the majority wouldn’t, is the data we have now even reliable?

Knowing that the opportunity was open to certain MAP participants who claim “it didn’t work” also raises questions about the quality of addiction rehabilitation treatment.   Unlike MAPs, abstinence-based treatment has been proven to work. Therefore, if there is ongoing negative feedback, perhaps there is more to the Canadian alcoholism issue than meets the eye.

Sources Are Strictly Canadian

The data is strictly focused on only one country – Canada. And what may work for one, will not work for another. Thus, all claims and data have to be questioned just because the information is limited from only one perspective. For example, NBA consumption is not really an issue in Scotland. Neither are homeless populations freezing in the snow. In Canada, however, both issues are serious.

Although the programmes offer support to those who want it, they do not appear to demonstrate a clear-cut plan on how to deal with alcoholism completely. And even if they did, they don’t seem to provide much motivation to change to a sober lifestyle.

Taking Out of Serious Treatment

Alcohol abuse is a serious problem in Scotland, but the same type of programme may not be as beneficial there as it is in other countries. MAPs are largely aimed at helping those who consume NBAs, which is not as common in Scotland as in Canada – as already stated.

In addition, the funding for managed alcohol programmes has to come from somewhere. Most likely, this would be the same source that funding for other drug and alcohol rehabilitation comes from. So, by using rehab-focused funds for MAPs, access to public funding for abstinence-based treatment centres will be harder.

In Scotland, where waiting lists for addiction treatment are already long, the introduction of MAPs might worsen the ongoing lack of resources. Since Scotland is unlikely to see benefits from MAPs, spending already limited funds on them will take away treatment from others.

Comments from Addiction Treatment Specialists

Professor Jonathan Chick, the Medical Director at Castle Craig Hospital advises caution regarding instituting a similar programme in Scotland, commenting:

“I am not convinced that the Canadians have actually shown evidence of the benefits of such programmes. 

Overall, the latest Canadian data from the six cities shows that the…. improvement in liver tests is transient. But the critical measure of alcohol-related problems, including medical and social and legal, could not be shown to be improved by MAPs…. There is [also] no evidence [that MAPs] improve health.”

He also believes that the decision to pilot a MAP project in Glasgow was rushed, adding, “There have been no outcomes published yet and it would have been preferable to wait until there was good evidence from the Canadian project and whether they had met the objectives they aimed for.”

Dr. Maria Kelly, Associate Medical Director at Castle Craig adds, “I believe those seen as eligible for MAP should be offered the chance to detox in a safe setting and receive abstinence based treatment. It may be helpful as a stepping stone to that chance. The risk with harm reduction as an end in itself is that it accepts inequality. I believe we should be striving to give everyone a chance to change their lives no matter how radically. We know that medical detox with rehabilitation can achieve that for anybody and the longer that safe treatment lasts the more chance even the most troubled addicted person can become free of dependence.

It has been wonderful to see the early results showing a real reduction in Scottish alcohol related harms related to MUP (Minimum Unit Price). Jonathan began work on that idea 20 years ago!”

Managed Alcohol Programmes Are No Good for Scotland

Most healthcare professionals today recognise that there is more than one way to recover from addictive behaviour.  At Castle Craig Hospital and Smarmore Castle, we work towards a goal of absolute sobriety but we are always ready to consider and to evaluate new approaches to tackling the problems presented by addiction.

Such problems may be medical, social, economic, or of some other kind and it may be that for some people, MAPs have a role to play in the same way that, for example, a methadone maintenance programme has for some.

If there are those that can benefit from MAPs, they likely have alcohol use disorder, not an addiction. In which case, someone who doesn’t want to quit but just learn to manage their drinking, can look for alternative approaches such as Moderation Management. 

Ultimately, at Castle Craig, we continue to emphasise the importance of abstinence. If someone suffers from alcoholism, complete sobriety is a proven route and can be the way to assure full recovery even for those who initially lacked social support and has damaged their health.

It’s essential to understand the regular attributes of alcoholism and consider different components when you think you or somebody you care about has a drinking issue. Keep on investigating the assets on this site and, when you are prepared, connect with one of our private treatment programme professionals. We have effectively treated a large number of individuals who’ve battled with alcohol abuse, drug dependency and gambling addictions.

In case you’re worried about alcoholism and stopping drinking, contact our 24-hour help-line team at +44-844-740-1394 or email us at with questions, remarks, or concerns.


Hidden Alcoholism and Secret Drinking

There is a saying in the addiction recovery community that goes something like this, “You’re only as sick as your secrets.” The meaning, of course, depends on who said it and in what context, but generally, we take it to mean that honesty is the best approach to facing addiction and seeking help.

Are you concerned about your own drinking habits and that you’ve lied about how much you drink? Do you keep alcohol hidden from friends and family? Or are you worried that someone else’s secret drinking is a sign that he or she is an alcoholic?

Underestimating Versus Lying About Drinking

A Canadian survey looked at “yesterday consumption” of alcohol to test the theory that adults tend to stretch the truth or underestimate how much they drink. They surveyed more than 43,000 Canadians and asked them about their daily drinking habits. They then asked how much alcohol they drank the day prior to the survey. Their theory was that if the respondent was honest about how much they drank the day prior, and it was significantly more than their average daily consumption, it’s likely that they underestimate how much they drink.

Before you hit “print” with the intent to show it to someone as proof that they’re lying or underestimating, let’s take a closer look at what secret drinking and hidden alcohol might mean.

What is Secret Drinking?

Secret drinking is a common practice among alcoholics who have a high tolerance for alcohol. Because they have to drink more to get the desired effect from alcohol, they might secretly drink before an event; some even have a name for this — pregaming.

If someone drinks alone, are they secretly drinking? No. The key differentiator here is intent. The secret drinker is hiding his drinking as part of a game plan. She’s hiding alcohol from friends, family, and others so it appears as if he or she had no more to drink than anyone else.

If someone close to you seems to drink in secret or habitually lie about how much they drink, that is a warning side that they have a problem. If you or someone you know hides alcohol or empty bottles in the trash, that too could be a sign of alcoholism.

How to Recognise Hidden Alcoholism

There are a few ways you can recognise signs of hidden alcoholism and secret drinking.

Some alcoholics prefer to drink vodka because it is clear and looks like water, and it doesn’t have the strong odours that other alcoholic beverages have. Just because someone prefers vodka doesn’t mean they’re an alcoholic. But someone who is hiding their vodka, filling water bottles with vodka, or appears to be pouring clear liquids into other nonalcoholic drinks (coffee, soft drinks or tea, for example) may have hidden alcoholism.

Another way alcoholics hide their drinking is by using secret flasks or vessels that are disguised as something else, such as a soda pop can, electronic devices, handbags, perfume and lotion bottles. Again, just because someone has these devices doesn’t mean they are alcoholics; these products are actually marketed to consumers as ways to sneak alcohol into events (which we would never advocate). However, if you see someone using one regularly or in an inappropriate way (at school, while driving a car, or in the lunchroom at work), it could be an indication that they have a drinking problem.

Alcoholics might also hide their drinking by tucking empty bottles and cans deep into their rubbish bins. They might also hide bottles in closets, deep in cabinets, or under and behind furniture. If you find bottles tucked away in these not-so-secret places, this could be a sure sign your loved one has a drinking problem.

Is Hiding Alcohol a Sign of Alcoholism?

A survey among Brits suggests that 27% of us have lied about our drinking habits, and the person we lie to the most is our healthcare providers.

  • 59% have lied to their healthcare providers
  • 43% have lied to their parents
  • 40% have lied to friends
  • 37% have lied to partners
  • 32% have lied to colleagues
  • 31% have lied to their children


Lying, however, does not suggest that someone is an alcoholic or problem drinker. Nor does it mean that every person who stretches the truth about how much they drink has a problem. It could be that it’s simply none of your business.

It’s important to understand the common characteristics of alcoholics and consider other factors when you think you or someone you care about has a drinking problem. Continue to explore the resources on this website and, when you are ready, reach out to one of our residential treatment programme specialists. We have successfully treated thousands of people who’ve struggled with alcoholism, as well as other types of addiction.

If you’re concerned about depression and quitting drinking, reach out to our 24-hour help-line specialists at +44 844 740 1394 or email us at with questions, comments, or concerns.

What is an Alcoholic? Characteristics & Levels of Alcoholism

An alcoholic is someone who has a physical and mental dependence on alcohol. We here at Castle Craig view alcoholism as a brain disease. Alcoholism is a serious psychological illness defined as the inability to stop drinking despite potential or actual, negative consequences. An alcoholic is someone who suffers from alcoholism.

4 common characteristics of alcoholics

You’ll find many definitions of “alcoholism” and “alcoholic,” most of which have these four characteristics in common:

  • Physical compulsion or need: Without a drink, withdrawal symptoms appear; you have an inability to stop or cut down on drinking.
  • Mental obsession: You lack control and have abnormal cravings or feeling of irritability in the absence of alcohol.
  • Negative impact: Drinking causes or contributes to problems with relationships, jobs, and finances.
  • Lying, hiding or downplaying: You’re dishonest with yourself and others about how much and how often you drink.

What is the definition of an alcoholic?

Some healthcare and mental health organisations have stopped using the word “alcoholic” because it has become a negative label used to shame people who have drinking problems. Instead, you may see these organisations refer to the person as having an alcohol use disorder.

Alcohol use disorder (AUD) is simply defined as “problem drinking that becomes severe.”

That leaves a lot of room open for debate, doesn’t it? How does one decide what “severe” means? Below are two resources that practitioners use to help diagnose and treat people with AUD. As always, take care when self-diagnosing; use these guidelines to educate yourself about AUD, and then seek help from licensed, experienced addiction professionals.

Are there different levels of alcoholism?

Does alcoholism fall on a spectrum? Are there different types of alcoholism? Is there a difference between a heavy drinker and alcoholism?

The NIAAA presents five subtypes of alcoholics, but again, this is for informational purposes only, not to cast blame or apply labels to you or someone you care about. Medical professionals use these subtypes to understand an alcoholic’s history and prescribe treatments. NIAAA’s subtypes are based on age and drinking behaviors:

  • Young adult subtype: 32% of alcoholics, these are defined as young adults who binge drink.
  • Young antisocial subtype: 21% of alcoholics, their average age is 26, they have an antisocial personality disorder, and they likely started drinking in their teens.
  • Functional subtype: 19% of alcoholics are middle age, educated, working and consume five or more drinks every couple of days.
  • Intermediate familial subtype: 19% of alcoholics started drinking in their teens, and they have family members with drinking problems.
  • Chronic severe subtype: 9% of alcoholics, mostly men with high rates of depression, divorce, financial problems and other drug use. Alcohol has completely taken over their lives.

The Health Department of the United Kingdom presents nine types of drinkers, all of which are based on motivations, rather than the NIAAA’s age and behaviors.

  • Border dependent: Has a combination of motives described below.
  • Bored drinker: Drinks to make up for the absence of people.
  • Community drinker: Alcohol forges a sense of security, meaning, and social networking.
  • Conformist drinker: The pub is their second home, and they feel a strong sense of community here.
  • Depressed drinker: Alcohol is a comfort and self-medication.
  • De-stressed drinker: Alcohol is used to relax.
  • Hedonistic drinker: Drinking releases inhibitions.
  • Macho drinker: Drinking asserts their masculinity and status; it provides false confidence.
  • Re-bonding drinker: Alcohol is a shared connector for this busy person.

Am I an alcoholic (quiz)?

You may be wondering whether you or someone you care about is an alcoholic. The two tools below are similar to those used by medical professionals to diagnose and treat people with AUD, but be careful with self-diagnosis. Use the tools to learn about alcohol and its negative effects, so you can take safe steps in seeking help.

NIAAA’s 11-point checklist for alcohol use disorder

The US-based National Institute on Alcohol Abuse and Alcoholism (NIAAA) provides an 11-point checklist, which practitioners can use to help identify whether someone is mildly, moderately, or severely affected by AUD (scroll down to read more about the different levels of alcoholism).

How many times in the past year have you …

  • Drank more or longer than you’d planned?
  • Wanted to stop drinking but couldn’t?
  • Spent a lot of time drinking and/or being sick afterwards?
  • Craved drink?
  • Found drinking to interfere with home, family, friends, work, or school?
  • Continued to drink despite problems?
  • Foregone doing something you love in favor of drinking?
  • Found yourself in dangerous situations while or after drinking?
  • Had blackouts or other medical problems caused or worsened by drinking?
  • Increased alcohol intake because you’ve built up a “tolerance”?
  • Experienced withdrawal symptoms when you didn’t drink?’s fast alcohol screening test (FAST)

The UK-based FAST is a matrix that helps practitioners assess alcohol problems. It is a scoring system that indicates risk levels for alcohol dependency.

How many times in the past year have you …

Use this as your scoring matrix for the questions below:

  • Never (0)
  • Less than monthly (1)
  • Monthly (2)
  • Weekly (3)
  • Daily or almost daily (4)
  1. Drank more or longer than you’d planned?If you score 3 or 4 on question 1, that is considered “FAST positive.” If you score 0-3, continue with the next set of questions.
  2. Wanted to stop drinking but couldn’t?
  3. Spent a lot of time drinking and/or being sick afterwards?
  4. Craved drink?

    If your score is FAST positive, answer the next questions to obtain a full audit score.
  5. Found drinking to interfere with home, family, friends, work, or school?
  6. Continued to drink despite problems?
  7. Foregone doing something you love in favor of drinking?
  8. Found yourself in dangerous situations while or after drinking?
  9. Had blackouts or other medical problems caused or worsened by drinking?
  10. Increased alcohol intake because you’ve built up a “tolerance”?
  11. Experienced withdrawal symptoms when you didn’t drink?

Total your score: 


  • 0-7 indicates low risk
  • 8-15 indicates increasing risk
  • 16-19 indicates high risk
  • 20+ indicates possible dependence

Is my loved one an alcoholic?

How much and how often does a person have to drink in order to fit the definition of an alcoholic or as having AUD? You’re doing the right thing by researching the answers to that question, but take care with how you use the information.

The NIAAA and FAST assessments can help you identify whether your loved one has a drinking problem. However, never use the information you find on the internet as a weapon to accuse, justify or, even worse, shame someone about their drinking. We have resources on our website that can help you understand things to remember when talking to an alcoholic friend or family member.

Get Help with Quitting Alcohol

If you identify with any of the definitions in this article, your concern about drinking may be justified. We encourage you to continue to explore our website to learn about addiction, treatment, recovery, and living a healthy and sober life. If you’re ready to talk to someone, we have recovery specialists on call 24 hours a day, seven days a week. Call +44-844-740-1394 or email us at with questions, comments, or concerns.

Fear and Loathing After Drinking – Can Alcohol Cause Depression?

The connection between drinking alcohol and depression is real, although which comes first — alcohol or depression — is up for debate. Does alcohol cause or worsen depression? Or does depression lead to alcohol misuse and abuse?

A group of researchers from Yale University in the United States sought to answer the following two questions:

  • How common are alcohol programs among people who suffer from depression? 

35 studies meeting criteria suggested that 16% of individuals diagnosed with depression presented with alcohol problems versus 7% among the general population. Hence, those with depression showed more than double the propensity to face alcohol problems.

  • Does alcohol affect depression? 

Study data showed that patients being treated for depression who also had alcohol abuse or dependence issues were associated with higher adverse clinical outcomes as well as higher correlated rates of suicide risk.

Does Alcohol Make Depression Worse?

The relationship between depression and alcohol is long, complicated and cyclical:

  • You feel down, low, depressed so you drink alcohol to feel better.
  • You drink to get relief from depressive thoughts, and you experience temporary feelings of elation.
  • After drinking, you sober up and feel guilty, which sends you deeper into depression.
  • You self-medicate with alcohol so you feel better
  • Life gets more difficult, and your drinking affects your relationships and your work.
  • You drink more to feel better… and the cycle continues …

That’s the emotional journey that someone who suffers from depression and alcoholism might go through, but what about the biological side of it? Let’s take a look at what we know from research about how alcohol affects the brain’s chemistry and why 95% of people who responded to a survey in Men’s Health said they’ve felt depressed after drinking.

The Science of Alcohol’s Effect on the Brain

You’ve probably heard that alcohol is a depressant, but what does that mean? How does alcohol affect the brain’s chemistry and lower our moods?

When you drink alcohol, it blocks chemical signals in your brain, which is why the more you drink, the more you experience symptoms of intoxication — slurred speech, lack of coordination, slow reflexes, and memory loss. Alcohol interferes with neurotransmitters in the brain, giving you false or temporary feelings like:

  • Increased confidence
  • Decreased inhibitions
  • Increased impulsiveness
  • More aggression and anger
  • Anxiety and depression

The effects of alcohol on the brain depend on a number of factors, including your age, your overall health, how much and how often you drink, the age at which you started drinking, and your genetics.

The more you drink, the more prone you are to experience anxiety and depression.

Over time, as you continue to drink, alcohol shrinks the hippocampus, which is the part of the brain that is responsible for memory and reasoning.

Alcohol also affects two very important chemicals in your brain — serotonin and dopamine.

Alcohol and serotonin

Serotonin is known as the “happy chemical” in your brain, because it contributes to your mood and feelings of happiness and well-being. When you drink alcohol, your brain produces more serotonin, which is why you temporarily feel happier. Over time, as you drink more, your brain slows production of serotonin, and that can lead to chronic depression.

Alcohol and dopamine

Dopamine lives in your brain’s “reward center.” It is a hormone and neurotransmitter that plays an important role in your feelings of pleasure and happiness. It also plays and important role in memory and your ability to focus. When you drink alcohol, you increase the release of dopamine, which is why for a short time while you drink, you think you feel better and happier.

Is Depression a Symptom of Alcohol Withdrawal?

Yes, depression is a common symptom people experience when they stop drinking, whether after a night of binge drinking or after a prolonged period of alcohol abuse.

It’s one of the reasons quitting alcohol cold turkey can be dangerous. Your brain relies on alcohol and stops producing its own neurotransmitters, so when you cut it off suddenly, the side effects can be dangerous. A common side effect is “delirium tremens,” which can include hallucinations, seizures and heart failure.

Get Help with Quitting Alcohol

Castle Craig’s residential treatment programme specialises in treating men and women who suffer from depression and alcoholism. We have successfully treated thousands of people who’ve struggled with depression and self-medicated with alcohol.

If you’re concerned about depression and quitting drinking, reach out to our 24-hour help-line specialists at +44-844-740-1394 or email us at with questions, comments, or concerns.